Robert M Grant, M.D., M.P.H., M.S.
Assistant Professor

University of California San Francisco
Box 1230
San Francisco, California 94143
phone: (415) 734-4810
fax:
email: robert.grant@ucsf.ed

Dr. Grant received in his M.D. degree from the University of California, San Francisco in 1988. Dr. Grant then completed a research fellowship in Molecular Medicine at University of California, San Francisco. After internal medicine, pulmonary subspecialty, and research training at University of California, San Francisco and the Gladstone Institute of Virology and Immunology, he joined the faculty of University of California, San Francisco in 1996. His major academic activities include directing the Gladstone-UCSF Laboratory of Clinical Virology, serving as Associate Director of the UCSF Center for AIDS Research, directing a research laboratory, and clinical practice in the Division of Pulmonary and Critical Care Medicine at San Francisco General Hospital.

Research Interests

I have 16 years of experience with HIV-1 related treatment and research, including 13 years of clinical experience caring for persons with AIDS, 2 years experience as a data analyst with the San Francisco Men’s Health Study, 2 years experience as an epidemiologist in Uganda, and 6 years experience in basic science laboratories at the Gladstone Institute of Virology and Immunology. My overall goal is to understand the biological basis for viral epidemic patterns, including host and viral evolution that underlies transmission between individual hosts and between host species.

In August of 1997, I became the Director of the Gladstone/UCSF Laboratory of Clinical Virology located at San Francisco General Hospital. The laboratory aims to bridge gaps between basic virology and problems of human health, especially AIDS. The laboratory is investigating (1) the prevalence of viral drug resistance in treated subjects and their sexual partners, (2) the transmissibility of drug resistant variants, (3) the viral fitness and cytopathicity of drug resistant variants, and (4) the role of host-directed therapy for targeting the reservoir of latently infected cells. The epidemic potential of drug resistant HIV-1 has been considered in mathematical models developed based on clinical and public health data from San Francisco. In addition, the laboratory supports a wide number and range of clinical and epidemiologic studies with "state-of-the-art" standardized virology assays.

The clinical and immunologic consequences of virologic failure of antiretroviral therapy and antiretroviral resistance have become the focus of my active research interest. We have described that the majority of patients who virologically fail antiretroviral therapy have sustained increases in circulating CD4+ T lymphocyte counts. Although partial drug susceptibility maintains viremia below pre-treatment levels accounts in many subjects with drug-selected HIV-1, this does not account for all of the immunologic benefit that persists during therapy. Experiments in the laboratory now focus on the specific virulence and replication fitness of drug resistant HIV-1.

Selected Publications

1. Grant RM, Wiley JA, Winkelstein W. The infectivity of the human immunodeficiency virus: estimates from a cohort of homosexual men. J. Inf. Dis. 1987;156:189-193.

2. Grant RM, Piwowar EM, Katongole-Mbidde E, Muzawalu W, Rugera S, Abima J, Stramer S, Kataaha P, Jackson B. Comparison of Saliva and Serum for HIV-1 Antibody Testing in Uganda Using a Rapid Recombinant Assay. Clin. Diag. Lab. Immunol., 1996;3(6):640-644.

3. Grant RM, Abrams DI. Not all is dead in HIV-1 graveyard. Lancet 1998;351(9099):308-309.

4. Hecht FM, Grant RM, Petropoulos CJ, Dillon B, Chesney MA, Hellmann NS, Bandrapalli NI, Digilio L, Branson B, Kahn JO. Sexual Transmission of an HIV-1 variant resistant to multiple reverse transcriptase and protease inhibitors. N. Engl. J. Med. 1998;339(5):307-311.

5. Palacios E, Digilio L, McClure HM, Chen Z, Marx PA, Goldsmith MA, Grant RM. Parallel evolution of CCR5-null phenotypes in humans and in natural host of simian immunodeficiency virus. Current Biology 1998;8:943-946.

6. Kaur A, Grant RM, Means RE, McClure H, Feinberg M, Johnson RP. Diverse host response and outcomes following SIVmac239 infection in sooty mangabeys and rhesus macaques. J. Virol. 1998;72(12): 9597-9611.

7. Deeks SG, Hecht FM, Swanson M, Elbeik T, Loftus R, Cohen PT, Grant RM. HIV RNA and CD4 cell count response to protease inhibitor therapy in an urban AIDS clinic: Response to both initial and salvage therapy. AIDS 1999;13 (6): F35-F43.

8. Deeks S, Barbour JD, Martin JN, Swanson MS, Grant RM. Sustained CD4 T cell responses after virologic failure of protease inhibitor based regimens in HIV infected patients. JID 2000;181:946-53.

9. Blower SM, Gershengorn HB, and Grant RM. A Tale of Two Futures: HIV and Anti-Retroviral Therapy in San Francisco. Science 2000;287:650-654.

10. Liegler TJ, Hayden MS, Lee KH, Deeks SG, Grant RM (2001). Protease inhibitor resistant HIV-1 from patients with preserved CD4 counts is cytopathic for activated CD4+ T lymphocytes. AIDS 2001;15:179-184.

11. Deeks SG, Wrin T, Liegler T, Hoh R, Hayden M, Barbour JD, Hellmann NS, Petropoulos CJ, McCune JM, Hellerstein M, RM Grant. Virologic and immunologic consequences of discontinuing combination antiretroviral drug therapy in HIV-infected patients with detectable viremia. N. Eng. J. Med. 2001;344(7):472-480.