Sequence-based RNA Fluorescence Assay to Measure Latent HIV Reservoirs

Project Summary/Abstract Public Health Problem. According to the World Health Organization (WHO), approximately 38 million people are currently living with HIV worldwide. Out of these, about 1.7 million were newly infected in 2019 alone. Moreover, around 690,000 people died from AIDS-related illnesses in the same year. Despite significant advances in therapies and accessibility to care and prevention methods HIV remains a global health challenge. The HIV epidemic has had a severe impact on vulnerable populations, exacerbating existing inequalities. Women and girls are disproportionately affected, accounting for over half of all new HIV infections globally. How Our Product Meets Unmet Needs. Jan Biotech has developed a nonezymatic, chemical amplification and direct detection assay for HIV RNA. HIVLatentDetect provides quick, sensitive, and quantitative measurement of cell-based HIV RNAs in HIV-infected individuals who are fully suppressed under antiretroviral treatment, including for 100% of acute/early HIV-infection treated individuals, for which QVOA, qPCR, ddPCR, IPDA, and single viral copy assays show a ≥25% rate of assay failure or no detection. HIVLatentDetect provided an unprecedented 0.92 (p-value≤0.0001) predictive value for time to HIV viral rebound after antiretroviral treatment interruption for the acute/early treated cohort in the AIDS Clinical Trials Group (ACTG) A5345. The HIV cure effort has a critical need for a biomarker assay capable of measuring/indicating the difference in time to viral rebound for each participating individual before and after a new treatment is administered. Such an assay would support empirical evaluation of potential cure treatments and improve the safety of participants in HIV cure clinical trials. Further, HIVLD has strong potential to change standard of care for early-treated HIV-positive individuals, indicating failure of an ART regimen prior to HIV virus production. Summary of Approach. Jan Biotech will perform needed sample testing to strengthen the assay’s statistical power, to participate in testing clinical trial samples to expand the assay’s predictive value for time to HIV viral rebound after treatment interruption, and to investigate the assay’s value for monitoring the response of participant’s HIV reservoir to potential cure treatments. This Phase IIB would also allow Jan Biotech to prepare the assay and equipment for commercialization and independent replication of the assay in the laboratories of leading HIV researchers. Collaborators and Unique Resources. Jan Biotech, Inc., with expertise in molecular diagnostic development, will collaborate with Dr. John W. Mellors, University of Pittsburgh School of Public Health, Dr. Michael Keefer, University of Rochester, Dr. Harris Gelbard, Director of the Center for Neurotherapeutics Discovery (CND) and a Professor of Neurology, Pediatrics, Neuroscience and Microbiology & Immunology at the University of Rochester Medical Center and the IVQAC team, led by Dr. Thomas Denny, and RAVEN, led by Dr. Michael Busch. Specific Aims Specific Aim 1: Commercial-readiness performance and shelf-life assay kit lockd Specific Aim 2: Equipment manufacturing and workflow optimizing Specific Aim 3: Independent laboratory replication of HIVLD assay Specific Aim 4: Comprehensive HIVLD assay quantification testing for early treated HIV Specific Aim 5: HIVLD assay testing for rebound prediction in HIV clinical trials Market after Completion. The end result of the project will be a validated sequence-based, quantitative HIV reservoir diagnostic assay and computational software to proceed to the FDA approval process, including additional preclinical and clinical evaluation leading towards 510(k) approval, clinical trials, and commercialization of an accurate, high-throughput HIV reservoir assay with remarkable prediction power for time to viral rebound after treatment interruption and thus of high value for HIV cure trials, research, and routine clinical use.