Brendan Osborne was actively engaged in the business end of research, working with universities and Networks of Centres of Excellence to help researchers take their discoveries to the marketplace. But while he enjoyed his work on the business side of things, he was always fascinated by what he saw on the research side. So when the economy took a downturn in 2008, he took the plunge into doctoral research at the University of Toronto.
“It was a bit of a jump,” says this CAHR doctoral research award winner. “But the recession made me think about what I really loved.”
And what he really loves, he says, is research with a strong clinical application.
His research ultimately focuses on understanding HIV transmission from a mucosal perspective in Toronto men. Anti-retroviral therapy (ART) is extremely effective at reducing the viral load found in blood and semen to undetectable levels in the majority of those treated. Yet, rarely, men on such treatment can still transmit the disease to their sexual partners.
Although the reason for this is currently unknown, some men on ART do shed HIV in their semen despite itbeing undetectable in their blood, posing a potential transmission risk. During these shedding episodes, men appear to have increased immune activation that is localized in their genital tract, and is not seen at all in their blood.
“For some reason, their immune system is just ramped up in the genital tract during these shedding episodes,” Osborne says, “and HIV divides at higher levels in immune cells that are ramped up like that.”
That means that using blood viral loads as a clinical marker might miss the small proportion of HIV-positive men who, despite the success of ART therapy, can still pose a transmission risk.
Osborne is currently engaged in research to better understand the shedding phenomenon, it’s causes, and whether an “intensified” antiretroviral therapy regimen consisting of five active antiviral drugs may help reduce its occurrence. A cohort of men has been followed longitudinally with regular sampling visits at the Maple Leaf Medical Clinic in Toronto, Ontario to research this.
Osborne is also investigating why some men with HIV who aren’t receiving ART have semen viral loads equal to, or greater than, their blood viral load, which doesn’t normally happen in this cohort. He is examining potential causes for this disproportionate HIV-1 semen shedding ,as it is known, including viral or bacterial infections that wouldn’t routinely be screened for.
Osborne’s research, which involves a motivated group of HIV-positive men at a Toronto clinic, could lead to a better understanding of HIV transmission in the male genital tract and perhaps help inform treatment to better control HIV replication in semen, one of the leading worldwide transmission mediums.
Says Brendan’s supervisor, Dr Rupert Kaul, “The work that Brendan is doing is really fascinating. Although it is the vector for most HIV transmission in the world, there is a reluctance to study HIV in the semen due to the ‘ick factor.’ There is no doubt that Brendan winds up having to deal with more than his fair share of bad puns and double entendres!”
Osborne attributes his success with his research in part to his business background, with its strong focus on outcomes, and in part to his funding from CAHR, which he describes as “a huge relief.”
“It’s very stressful not having funding. It helps to alleviate a lot of stress when you get a stable source of funding.”