ART Modulation of Viral Pathogenesis

ABSTRACT This is the renewal application of 5R01DE018304-15. It responds to NOT-DE-25-038 / "Basic and Translational Oral Health Research Related to HIV/AIDS." Kaposi Sarcoma (KS) is the most common cancer in people living with HIV today, whether in the US or in Sub-Saharan Africa, where the majority of PLWH reside. KS can form in the oral cavity. Oral KS is considered a marker-aggressive disease. KS can occur in severe immune- compromised people but also in PLWH, in whom ART suppresses HIV replication to below 50 copies/ml. Kaposi sarcoma herpesvirus (KSHV) is entrenched in populations for increased risk of HIV acquisition, including members of racial and socioeconomic minorities. Not much is known about the effect of ART on Kaposi sarcoma- associated herpesvirus (KSHV) oral transmission, oral and systemic KS disease, or the latent KSHV reservoir. We propose to investigate the impact of ART in the context of chemotherapy for KS and define novel disease biomarkers. We apply advanced technologies and analytics to one of today's largest clinical trial collections to allocate HIV+ KS patients to the best therapy for them.