Grant: Chair: GlaxoSmithKline Partnered

HIV is a virus that destroys the immune system. If untreated, it typically leads to the fatal disease called AIDS (Acquired Immune Deficiency Syndrome) within 10 years. Over 70,000 Canadians have HIV. HIV infection can be treated with a life-long drug cocktail known as highly active retroviral therapy or HAART. This therapy has transformed HIV into a more manageable chronic condition. HIV treatment works by greatly reducing the amount of virus in the bloodstream. This not only prevents AIDS, but also reduces the chances of transmitting HIV to others. Treating HIV therefore yields both individual and public health benefits. Our group has spearheaded the "Treatment as Prevention" strategy in British Columbia, with the goal of virtually eliminating AIDS and HIV transmission. President Obama has embraced it as a cornerstone of the US approach in Africa, seeking an AIDS-Free Generation. However, resistance to these drugs can occur and be the major cause of treatment failure, threatening the success of these initiatives. Using cutting-edge DNA sequencing technologies, we will develop new methods for personalized delivery of HIV therapies: 1) We will introduce an improved HIV drug resistance test based on the latest DNA sequencing technology and share our methods and computer software with laboratories worldwide. The benefits of this improved test will be increased numbers of patients receiving effective HIV treatments. 2) We will implement new systems for real-time HIV drug resistance surveillance in Canada. This active monitoring approach will detect geographic or population "hotspots" with high rates of drug resistance, reducing the risk of transmission of HIV and drug resistant HIV in the population. 3) We plan to develop and validate improved methods for individualised treatment of HIV based on human genetics. The benefit of this testing would be reduced rates of unwanted drug side-effects and a lower risk of needless medication exposure.