Doctor of Philosophy (Ph.D.), Bowling Green State University, 2021, American Culture Studies

From 1981-1996, the United States experienced an epidemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) that held profound implications for issues ranging from civil rights, public education, and sexual mores, to government accountability, public health, and expressions of heterosexism. Popular comic books that broached the subject of HIV/AIDS during the U.S. epidemic elucidate how America's discourse on the disease evolved in an era when elected officials, religious leaders, legal professionals, medical specialists, and average citizens all struggled to negotiate their way through a period of national crisis. The manner whereby comic book authors, illustrators, and publishers engaged the topic of HIV/AIDS changed over time but, because comic books are an item of popular culture primarily produced for a heterosexual male audience, such changes habitually mirrored the evolution of the nation's mainstream, heteronormative debates regarding the epidemic and its sociocultural and political implications. Through studying depictions of the HIV/AIDS epidemic in popular comic books, alterations in the heterocentric, national discourse emerge revealing how homophobic dismissals of the “gay plague” in the early 1980s gave way to heterosexual panic in the mid-1980s, followed by the epidemic's reinterpretation as a national tragedy in the late-1980s. Ultimately, this study uncovers how, in the early 1990s, HIV/AIDS awareness became a national cause celebre and a fad effectively commoditized by the economic forces of American popular culture until its novelty waned when the epidemic phase of the U.S. HIV/AIDS crisis drew to a close in the mid-1990s. Throughout, representations of HIV/AIDS in popular American comic books show how comic book creators sought to elevate their medium beyond the confines of its perceived juvenile trappings by exploring topical and controversial material that would appeal to the expanding market of adult buyers that blos (open full item for complete abstract)

Doctor of Healthcare Administration (D.H.A.), Franklin University, 2021, Health Programs

Routine HIV testing for adults 65 years and older is imperative for prevention and treatment efforts among the vulnerable population. To date, limited research exists that examines associations between sex in HIV testing, HIV risk perception, and HIV risk among adults who are 65 years and older. Certain risk behaviors can lead to missed testing opportunities for some Medicare beneficiaries aged 65 and older, increasing the likelihood of new HIV transmissions and late-stage diagnoses. A federal mandate requires that Medicare Part B (outpatient insurance) cover annual wellness visits, which allow providers and beneficiaries to develop personalized prevention plans of care. However, Medicare does not offer routine HIV testing to beneficiaries 65 years and older, unless they specifically ask for a test (risk perception) or considered at risk (actual risk). This quantitative, cross-sectional, causal-comparative research design was guided by the health belief model (HBM) and theory of gender and power (TGP). Chi-square tests analyzed secondary data from the 2018 National Health Interview Survey, Adult Sample file regarding HIV testing, HIV risk perception and HIV risk among non-institutionalized adults, 65 years and older. The significance of statistical tests was determined at the .05 alpha level. Study findings revealed a significant association between sex and HIV testing prevalence, with men (24.3%) testing more frequently than do women (20.1%). Findings also revealed a significant association between sex and HIV risk. Men (41%), when compared to women (22%), were almost twice as likely to have at least one factor increasing HIV risk. There was no significant association between sex and HIV risk perception. Findings revealed that both men (99.6%) and women (99.6%) equally lacked HIV risk perception.

Doctor of Philosophy, Case Western Reserve University, 2008, Molecular Biology and Microbiology

In the advent of the promise for HIV-1 entry inhibitors to treat patients with drug resistance to available antiretroviral therapy, there has been a surge in studies related to HIV-1 entry. It is clear that the intrinsic susceptibility of primary virus isolates to entry inhibitors varies, which indicates a greater probability for intrinsic resistance to this class of drugs. The studies presented here provide tools and insights into the impact of the envelope (env) gene on HIV-1 replicative capacity, how that capacity influences the emergence of drug resistance, and how easily drug resistance is selected in vivo to a microbicide entry inhibitor. The fitness of a virus is a marker of its replication capability in a given environment. The specific impact of HIV-1 entry on the overall fitness of a virus was tested by cloning a region of the env gene into a common backbone and comparing the resultant recombinant fitness to that of the wildtype virus. The env gene was sufficient to determine the overall fitness of these viruses, which also correlated with sensitivity to entry inhibitors. Specifically, the binding avidity of a virus to the host cell coreceptor contributed the most to fitness. PSC-RANTES is an entry inhibitor that acts on the coreceptor CCR5 to block HIV-1 binding and down-regulate coreceptor expression. When used as a microbicide in a rhesus macaque model, PSC-RANTES failed to block transmission of SHIV¬¬¬SF162 at high doses in some animals. Two mutations were identified in isolates from one of these animals and were cloned into a common HIV-1 backbone to create a chimeric virus. The chimeric virus exhibited resistance to PSC-RANTES and an increase in fitness over that of the wildtype virus used to infect the rhesus macaques. This study showed for the first time the selection of drug resistant viruses to a microbicide in an HIV-1 animal model system. Lastly, a cloning strategy was developed to quickly create replication-competent, fully infectious HIV-1 ch (open full item for complete abstract)

PhD, University of Cincinnati, 2015, Nursing: Nursing - Doctoral Program

Background: Despite tremendous advances in HIV treatment, less than 30% of the more than 1 million people living with HIV in the US are achieving optimal treatment outcomes. Researchers have recognized that there is an urgent need to understand factors and processes that influence individuals with HIV to initiate HIV care. Purpose: The specific aims of the study were to develop a theoretical framework to explain the psychosocial process of care initiation in individuals living with HIV to identify the critical junctures, defined as pivotal events reported by study participants, that influence individuals living with HIV in their decision to initiate HIV care Methods: Grounded theory was the method used to analyze in-depth interviews with individuals living with HIV. A team of IRB-approved researchers analyzed the data using three levels of coding: Open coding, selective coding, and theoretical coding. Analysis was conducted with an aim of identifying the psychosocial process of care initiation by individuals living with HIV. Results: 30 individuals living with HIV (28 men, 2 women) participated in the study. Participants shared their stories about how they went from learning that they had HIV to the point of HIV care initiation. The core category discovered in the data was concept of HIV as news. News, by definition, is impactful information that was not previously known that is delivered by one party and received by another. Participants described a process in which they progressed through five distinct stages: a) receiving the news, b) interpreting the news, c) incorporating the news, d) acting on the news, and e) moving beyond the news. Each stage was moderated by influential factors including perceived susceptibility to HIV infection, symptoms, HIV information, and feedback from others. The initial receipt of the news was typically interpreted as `bad news'. However, through reflection, interaction with others, and information seeking, participants l (open full item for complete abstract)

Master of Sciences, Case Western Reserve University, 2009, Epidemiology and Biostatistics

Understanding sexual behaviors of persons on Antiretroviral therapy(ART) is critical designing and implementation of positive prevention programs. 559 HIV infected adults were enrolled in clinic based prospective observational study and sexual behaviors ascertained at ART initiation and semi-annually thereafter. Using Logistic regression with generalized estimating equations, factors associated with sexual activity and unprotected sex were examined. Over the first three years of ART, the proportion sexually active did not change at ~52% (χ2 Trend, p=0.94) while the proportion reporting unprotected sex decreased (χ2 Trend, p<0.0001). Men reported unprotected sex less often than women (p<0.0001). In all analyses, having no children and female gender (controlling for any other factors) was associated with the practice of unprotected sex. The interventional effect of comprehensive HIV care resulted in marked reductions in unprotected sex particularly among men. Strengthening of positive prevention interventions, especially among females are needed in ART programs in this setting.

Doctor of Healthcare Administration (D.H.A.), Franklin University, 2021, Health Programs

Globally, 37.8 million people were living with human immunodeficiency virus and acquire immunodeficiency syndrome (HIV/AIDS) in 2018, with 1.7 million new cases reported and 57% receiving antiretroviral therapies. Nearly 76,000,000 people have been diagnosed with HIV and an estimated 33,000,000 people have died of HIV/AIDS since the beginning of the epidemic. The focus of this research was to investigate the perspective of persons living with HIV in respect to their relationship with their provider, provider communication, accessibility, and their perceived quality of care before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic using a cross-sectional quantitative analysis. This cross-sectional quantitative study was conducted to ascertain whether a relationship exists between provider patient relationship, communication, accessibility and convenience, and perceived quality of care from the perspective of patients living with HIV before and during the SARS-CoV-2 pandemic using a regression analysis. Fifty-eight individuals participated in the study and their responses were anonymous. The study was guided by a patient-centered care model as an approach to inform health care providers who are providing services in HIV care.

EdD, University of Cincinnati, 2005, Education : Urban Educational Leadership

Historically, the issue of HIV and adolescence has not generally been considered a priority for most school educators and administrators. As treatments for HIV have advanced over the years, more students infected by the disease have been able to participate in learning environments in the public schools. With the No Child Left Behind Act permeating schools, urban administrators, and educators are forced to focus primarily on academically based achievement standards; negating the social, medical, legal, and moral complexities of students who are infected with HIV. The purpose of this research was to explore the attitudes of administrators and teachers in urban schools. This study found that their attitudes about HIV and HIV positive adolescents centered on 3 main themes:(1) the (non)compassion on the part of the administrator or teacher depending on the mode of HIV transmission, (2) their beliefs about factors that impede student learning, and whether a medical condition can be considered an impediment, and (3) the professional experience of the administrator and teacher that impacts school change.

Doctor of Philosophy, Case Western Reserve University, 2009, Epidemiology and Biostatistics

Background: Latinos in the United States are at high risk for depression, anxiety, and substance abuse and HIV/AIDS has excessively impacted this community. Individuals with severe mental illness (SMI) are more likely to engage in HIV high-risk behaviors. A range of psychiatric and social factors have been considered as correlates of sexual risk behavior with findings indicating a need for future studies to provide insight into the direction and nature of these associations. Objective: To describe the HIV-risk behaviors of Puerto Rican women with SMI in Cuyahoga County, Ohio using quantitative and qualitative techniques. Aim 1 investigated the association of childhood sexual abuse (CSA) and adult HIV-risk behaviors using a retrospective cohort design. The second aim examined psychiatric and social correlates of HIV sexual risk behavior and aim 3 compared data obtained qualitatively to data obtained quantitatively using criterion validity. Methods: The study sample consisted of 53 Puerto Rican women with SMI recruited between October 2002 and December 2005. Consenting participants participated in a baseline interview, two follow-up, semi-structured interviews, and up to 100 hours of non-continuous participant observation. Descriptive, bivariate, and multivariate analyses were conducted to describe HIV-risk behaviors and assess the efficacy of two data collection methods. Results: The relationship between CSA and HIV-risk may be mediated by partner abuse and mental illness diagnosis. Psychiatric and social factors were differentially associated with sexual risk behaviors and multivariate analysis showed that increased severity of psychiatric symptoms and factors and living below the poverty line are predictive of sexual risk behaviors. The correlations between quantitative and qualitative responses concerning sexual and drug use behaviors revealed agreement in some cases and inconsistencies and contradictions in others. Conclusions: Puerto Rican women with SMI are in (open full item for complete abstract)

Master of Arts, The Ohio State University, 2007, Graduate School

PHD, Kent State University, 2024, College of Public Health

The purpose of this sequential explanatory mixed methods study was to explore HIV risk perception, the meaning of HIV testing, and HIV risk behavior among college students following a negative HIV test. An extended version of the theoretical framework of the health belief model (HBM) aided in the exploration of college students' perceptions of HIV, rationales for HIV risk behavior, and the meaning they attached to HIV testing. Following the sequential explanatory mixed methods design, the initial phase involved collecting quantitative data to assess HIV risk perception among college students who received a negative HIV test in the last 12 months. In the second phase, interpretative phenomenological analysis (IPA) was applied to gather data through individual semi-structured interviews to help explain HIV risk behavior in the context of HIV testing. Findings indicated that college students' perception of their HIV risk is aligned with their risk behavior. Results showed a statistically significant difference in HIV risk perception based on sexual orientation. Before HIV testing, college students justified their HIV risk behavior based on partner trust, not wanting to feel restrained, and acting on the need to fulfill their desire, lust, or temptation. After receiving a negative HIV test result, college students still experienced fear of contracting HIV. However, some students became more cautious and adopted preventive measures, while others continued with previous behavior patterns. Implications of the research findings include examining risk perception across college students of different sexual orientations to understand the impact of risk perception in HIV testing and exploring the differing needs of college students to remain HIV-negative. Participants recommended that colleges address access to free HIV testing, increase information dissemination regarding HIV risk and HIV testing services, and continue research that explores college students' lived experiences (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2021, Microbiology

Viruses regulate host cell metabolism to promote infection. Fatty acid synthase (FASN) is a host enzyme that catalyzes palmitate synthesis by condensing acetyl and malonyl CoA. FASN is involved in the replication of the Human Immunodeficiency Virus-1 (HIV-1) and the Severe Acute Respiratory Syndrome Coronavirus type -2 (SARS-CoV- 2). FASN is found in the plasma of people living with HIV-1. The role of FASN in the extracellular milieu and its role in HIV-1 and coronavirus replication remain understudied. To study extracellular FASN during HIV-1 infection, we assayed FASN levels in longitudinal plasma samples from people with and without HIV-1. We found that people living with HIV-1 had eight- to ten-fold higher levels of plasma FASN relative to people without HIV-1. To understand FASN's role in the extracellular milieu, we exposed PBMCs to recombinant FASN and found increased secretion of TNF-α and IL-1β compared to exposure to the FASN vehicle control. If confirmed through follow-up studies, this would uncover a cytokine-like function for FASN. Fatty acids generated through FASN can be used for protein acylation, which is traditionally difficult to study. We developed a cell-permeable, click chemistry– compatible alkynyl acetate analog (Alk-4) that functions as a reporter of FASN dependent protein acylation. We showed that Alk-4 selectively labeled the cellular protein interferon-induced transmembrane protein 3 at its known palmitoylation sites and the HIV-1 matrix protein at its known myristoylation site in a FASN-dependent manner. Alk-4 also enabled biotin-based recovery of more than 200 FASN-dependent acylated cellular proteins. Alk-4 enabled the study of FASN's role in Gag myristoylation in HIV-1 infected cells, a process critical for membrane targeting of Gag. Using click chemistry and immunofluorescence techniques in Alk-4 labeled, HIV-1 infected cells as well as proximity ligation assays that produce a signal depending on the spat (open full item for complete abstract)

PhD, University of Cincinnati, 2021, Arts and Sciences: Geography

In public health, certain population groups (termed as vulnerable populations) are at an elevated rate of morbidity and mortality for particular diseases. Vulnerable groups usually experience poorer health outcomes and healthcare attention compared to the general population1. For this dissertation, the groups (mobile individuals, women, and African Americans) and diseases (HIV, COVID-19 and Anemia) of interest present particular geographical distributions that are worthy of study because of the need to understand uneven spatial pattern distributions, locate populations at risk, and to devise geographically-targeted interventions. Also, the reasons behind their distribution might differ not only because of a disease's biological features but also due to several drivers including, sociodemographic characteristics, economic activities, or built-environmental conditions associated with a specific area, region or country. Previous studies have evaluated the geographical variation and the contribution of risk factors in HIV, COVID-19 and Anemia. Although these studies showed evidence of the spatial variation of these diseases, they were geographically and epidemiologically limited, with scarce information available for vulnerable populations such as mobile individuals, women, and African Americans. Therefore, this dissertation aims to investigate the contribution of geographic-based risk factors to elevated rates of morbidity and mortality in both well-established (HIV and Anemia) and novel diseases (COVID-19) in the aforementioned groups using geography. I hypothesize that medical geography is the right choice to understand the contribution of geographic-based risk factors to disease variations in vulnerable groups from a geographical standpoint. Moreover, to support my hypothesis about the ability of geography to study spatial variation of diseases, chapters 2, 3, and 4 corresponded to three peer-reviewed medical geography articles with emphasis in vulnerable populatio (open full item for complete abstract)

Doctor of Philosophy, Case Western Reserve University, 2020, Anthropology

This research investigates political and economic issues of inequality and unemployment in Uganda, as manifested in one informal settlement in Kabalagala, and the effect of these issues on HIV. Uganda is one important site to study the intersections of inequality, formal sector unemployment, urbanization, and HIV/AIDS. Contemporary inequality and formal sector unemployment are driven by colonial policies that shaped urban stratification, and postcolonial policies that privileged economic growth over job creation. A central goal was to understand men's risk of HIV in the context of these and other structural and social drivers of risk. This research used an explanatory sequential mixed methods study design, including a pilot study (2016), survey pre-test (2017), and 12 months of fieldwork that began with survey data collection (N = 292) and ended with in-depth interviews (n = 54, a subset of the survey sample). Survey data were analyzed using multiple linear regression, and interview data and field notes were analyzed through thematic analysis. Quantitative data described the patterning of risky sexual behavior (e.g. HIV risk), while qualitative data expanded on these relationships and helped to clarify areas of contention. Men in this study have lower rates of HIV testing, compared to national averages. Men also frequently report defaulting on ART, once they do receive a positive diagnosis and begin treatment. Inequality and unemployment impact their daily lives through experiences of uncertainty that must be managed. Economic instability is important, and when men cannot access resources, they are likely to engage in a variety of strategies to improve their economic status. Men also face myriad vulnerabilities driven by the political-economic context, from housing instability to incarceration. This work contributes to the anthropological literature on the political economy of health, HIV, vulnerability, and social resilience. Men's experiences of HIV and (open full item for complete abstract)

MS, University of Cincinnati, 2019, Medicine: Biostatistics (Environmental Health)

In Ghana, men who have sex with men (MSM) are 15 times more likely to live with HIV compared to the general adult population, and rates of engagement in medical care for HIV are low among MSM diagnosed with HIV. Using structured survey interviews, we investigated the impact of HIV-related stigma (deconstructed into four components: enacted, felt normative, vicarious, and internalized HIV stigmas), same-sex behavior stigma, and gender nonconformity stigma on linkage to HIV care in 225 MSM living with HIV in Ghana. We found that vicarious HIV stigma (i.e., hearing stories of HIV discrimination) positively predicted linkage to care, such that MSM were three times more likely to be linked to care for each unit increase in vicarious stigma scale. Conversely, we found felt normative HIV stigma (i.e., perception of pervasiveness of HIV stigmatization) to negatively predict linkage to care, such that odds of being linked to care were decreased by 37% for each unit increase in felt normative scale. Perceived autonomy-supportive healthcare climate was a positive predictor of linkage to care, such that MSM were twice as likely to be linked to care for each unit increase in healthcare climate score. Finally, we identified locational differences in linkage to care, such that MSM in Takoradi were over three to four times more likely to be linked to care compared to MSM in Greater Accra or Kumasi. Ultimately, our findings highlight the nuanced roles that stigmas can play in shaping care-seeking behaviors and illustrate the need for open-minded perspectives of inquiry towards understanding engagement in the HIV care cascade for marginalized populations.

Doctor of Philosophy, The Ohio State University, 2018, Pharmaceutical Sciences

Human Immunodeficiency Virus type 1 (HIV-1) is the agent culpable for the malady known as acquired immune deficiency syndrome (AIDS). HIV is a single stranded positive sense RNA virus whose replication is dependent upon the utilization of a DNA intermediate. An indispensable stage in its life cycle is the integration of viral DNA into the host chromatin which is catalyzed by the viral protein integrase (IN). HIV-1 IN interacts with cellular protein lens epithelium derived growth factor (LEDGF)/p75, a cellular cofactor which forms a bimodal tether between chromatin and IN. This interaction has been shown to contribute to HIV-1 integration into host chromatin and has recently become a tantalizing target for antiretroviral therapies. Presently there are more than 35 FDA approved HIV-1 inhibitors, with three of these being IN strand transfer inhibitors (INSTIs). Unfortunately, drug resistance remains problematic in the clinic and the generation of novel inhibitors is essential. Therefore, our work focuses on developing innovative therapies through better understanding of the interactions of current inhibitors, as well as on elucidating the mechanisms of HIV-1 drug resistance. Specifically, my research has centered on better understanding of the mechanism of resistance to allosteric HIV-1 IN inhibitors (ALLINIs) as well as elucidating the role of cellular cofactor LEDGF/p75 on these new inhibitors. Chapter 1 introduces HIV-1 in its historical context, as the source of the AIDS pandemic and current and developmental biologics. The discussion of the replication cycle of HIV-1 leads to three essential proteins to my work; HIV-1 IN and protease (PR) as well as cellular protein LEDGF/p75. In particular, this chapter focuses on current therapies, drug resistance, and the biological role played by HIV-1 IN. This is done in four distinct sections: (I) analyzing the mechanism of inhibition of the FDA approved INSTIs that target HIV-1 IN's active site; (II) evaluation of thei (open full item for complete abstract)

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2018, Psychology/Clinical

HIV/AIDS continues to be a problematic disease that affects all ethnic groups. Latinos are likely to experience challenges associated with poor quality of life, HIV stigma, language, and cultural barriers. Latinos are also at risk of experiencing multi-layered stigma. Acceptance and Commitment Therapy (ACT) has been associated with improved health outcomes among diverse medical and psychiatric populations, including HIV. However, the potential benefits of a mindfulness based intervention have not been explored among Latinos with HIV. The primary goal of this study was to develop and empirically evaluate a brief ACT protocol tailored to HIV-positive Latino individuals living on the U.S./Mexico border with the goal of improving quality of life and reducing HIV stigma. Two separate sets of data are presented. Study 1 evaluated cross-sectional data on measures of acceptance, cognitive fusion, quality of life, viral load, and language among HIV-positive Latinos. Study 2 evaluated the feasibility of a one-day, three-hour ACT group to improve quality of life and reduce HIV stigma. There were three primary hypotheses for this study: a) acceptance would be positively associated with quality of life and lower HIV stigma and viral load; b) cognitive defusion would be positively associated with quality of life and lower reports of HIV stigma and viral load; and c) participants in the ACT group would report improved quality of life and reduced HIV stigma at posttreatment and follow-up assessments compared to pretreatment assessment and to participants attending an HIV education group. Correlational and regression analyses were conducted to evaluate associations among all study variables. Repeated measures ANOVA, nonparametric analyses, and single-subject analyses were conducted to evaluate treatment outcome data. Results were mixed and provide only partial support for study hypotheses. The ACT intervention was not helpful in reducing reports of HIV stigma or improving quality (open full item for complete abstract)

Doctor of Philosophy, University of Toledo, 2016, Counselor Education and Supervision

Individuals infected and affected by the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) have distinctive mental and emotional health issues (Acuff et al., 1999; Badiee et al., 2012; Hult et al., 2007). This study sought to create an instrument that measures the attitude element of competency with the development of the Mental Health Professionals' Attitude Towards People Living with HIV/AIDS (MHP-PLHIV-AS). After the MHP-PLHIV-AS's creation by a Content Evaluation Panel of HIV/AIDS Experts, it was piloted for calibration with a sample of mental health professionals (n = 43), then administered to a larger sample for validation (n = 454). The newly designed MHP-PLHIV-AS was analyzed through a Rasch Measurement Model (RMM; Rasch, 1960, 1980). RMM diagnostics and analyses provides evidence to support a two-dimensional (societal and personal dimensions) measurement of the attitude towards PLHIV construct. The authors provide background, processes, and results of the study, and implications not only for the use of the MHP-PLHIV-AS, but also of attitude being a two-dimensional construct.

Doctor of Philosophy, Case Western Reserve University, 2016, Epidemiology and Biostatistics

This is a study to evaluate cross-sectional and longitudinal genetic associations among Metabolic Syndrome (MetS) risk factors and a select set of candidate genes involved in inflammatory, vasoconstrictive, and coagulation processes at the vascular epithelium in the Women's Interagency HIV Study (WIHS) Cohort. We conducted a candidate gene association analysis of multiple clinical measures for each component trait of MetS in a group of HIV-positive and -negative women of the WIHS. Thirty-two candidate genes were selected based on their pro-inflammatory, pro-vasoconstrictive, and pro-coagulative functions and expression in the vascular endothelium. The association was modeled with mixed effects model with both random slope and random intercepts. We have identified genetic variants in CKD14 and NFKB1 with longitudinal effects on MetS risk factors in African Americans and Hispanics. We provide evidence that the genetic architecture of MetS includes genes previously implicated in inflammation (NFKB1) and vessel repair (CDK14) and that HIV may mediate the magnitude of the some genetic associations.

Master of Science (MS), Wright State University, 2008, Microbiology and Immunology

Eosinophils express membrane CD4 protein and can bind HIV-1 glycoprotein (gp) 120. Therefore, eosinophils could serve as host cells for HIV-1 infection in vivo, especially in the late phase of the infection. In culture, HIV-1 infects eosinophil precursors and primary eosinophils. Additionally HIV-1 proviral DNA sequences have been detected in the eosinophils of some HIV-1 positive patients. Since elevated levels of eosinophils occur during HIV-1 infection and parasitic infections, it implies that co-infection of parasites and HIV-1 could cause a much greater increase in the level of potential HIV-1 susceptible eosinophils. Therefore HIV-1 infection of eosinophils could partly explain the rapid spread of HIV-1 and the exacerbation of the disease especially in developing countries where HIV-1 and parasitic infections run concurrently. This study is a critical analysis of the current knowledge on HIV-1 infection of eosinophils focused on highlighting evidence that HIV-1 can productively infect mature human eosinophils in HIV/AIDS patients.

Master of Science (MS), Wright State University, 2006, Microbiology and Immunology

Over the past two decades, much research has been done in the field of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). However, many of the aspects of pathogenesis of HIV infection and its persistence in the body, despite treatment, remain a mystery. Recent evidence suggests that HIV positive patients develop eosinophilia, especially in the later stages of infection and AIDS. Eosinophils are CD4 positive cells that have the potential to be infected by HIV. Studies have shown that an eosinophilic cell line, AML14.3D10, can be productively infected with a T-cell tropic, CXCR4-using (X4) strain of HIV-1. In this study, primary human eosinophils from four healthy volunteers were shown to be susceptible to infection with a T-cell tropic, CXCR4-using (X4) strain of HIV-1, HTLV-IIIB. This data was supported by results from quantitative polymerase chain reaction (Q-PCR), which detected high HIV copy numbers in infected eosinophil samples. In two out of four donors, these copy numbers were comparable to those obtained from infected AML14.3D10, used as a positive control. In all four donors, the number of viral copies detected in infected eosinophils were significantly (p<0.05) higher than those detected in infected peripheral blood mononuclear cells (PBMCs). Donor variability was observed in viral loads detected. No correlation was observed between the viral load and the production of p24. However, infected eosinophils showed higher amounts of p24 production, as compared to infected PBMCs with or without IL-2, in three out of four donors suggesting productive infection. Therefore, it is concluded that primary human eosinophils are susceptible to productive infection by X4 HIV-1.