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Abstract

In the absence of a prophylactic vaccine and curative strategies, the daily use of antiretroviral therapy (ART) is essential for preventing and maintaining HIV infection. Although ART plays a vital role in decreasing the numbers of new infections and AIDS-related deaths, transforming this once deadly disease into a manageable condition, we are also observing an increase in global antiretroviral (ARV) drug resistance. Because ART requires daily oral use for a lifetime, suboptimal treatment adherence will accelerate the development of drug resistance. To combat this problem, multiple classes of ARV drugs with different mechanisms of action are being incorporated into first-line drug regimens; however, drug resistance against newer forms of ARV drugs will ultimately rise with increasing usage. To this end, investigating different drug targets with higher genetic barriers to resistance and drug formulations to allow for less frequent dosing will aid in the slowing of the HIV epidemic. This dissertation hypothesizes that an anti-CCR5 antibody Leronlimab (PRO 140; PA14) can phenocopy the natural resistance observed in homozygous CCR5D32 individuals to prevent viral acquisition and suppress viremia.

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