Professor Sarah Palmer
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Professor Sarah Palmer

PhD
Professor
The Westmead Institute for Medical Research
Faculty of Medicine and Health
Professor Sarah Palmer

Dr. Sarah Palmer is the Co-Director of the Centre for Virus Research at The Westmead Institute for Medical Research and Professor in the Faculty of Medicine and Health, The University of Sydney School of Medicine.

Prior to taking up this position in early 2013, she was a Senior Researcher at the Swedish Institute for Communicable Disease Control and Karolinska Institutet, in Stockholm, Sweden from 2008 to 2012. From 2000 to 2008, she headed the Virology Core Facility of the HIV Drug Resistance Program, National Cancer Institute, US National Institutes of Health, where she led efforts to develop and perfect highly-sensitive assays such as the single-copy assay and single-cell sequencing assay which provide new insights into HIV pathogenesis and persistence during long-term suppressive therapy.

Dr. Palmer has her Ph.D. in Medical Sciences (Virology) from the Karolinksa Institutet, and conducted her post-doctoral studies at the Center for AIDS Research, Stanford University Medical School.

HIV Pathogenesis and HIV Reservoirs: Our group’s principal areas of research interest focus on molecular and medical virology and the application of innovative techniques and assays which provide new insights into disease pathogenesis and treatment, especially for HIV. Our current work focuses on understanding the genetic characteristics and dynamics of persistent HIV across a range of tissues and cells to guide and assess treatment interventions designed to reduce persistent HIV reservoirs and inform HIV eradication strategies.

COURSES TAUGHT

Infection: Causes and Defense: preclinical lectures for medical students

Antiviral Therapy Seminars: preclinical seminars for medical students

New Insights into the Host-HIV Relationship: graduate student lecture series

Virology and Antiviral Therapy: undergraduate students in biomedical technology

DARE: Delaney AIDS Research Enterprise to find a cure: Our research group is a part of an ongoing international initiative concerned with HIV eradication strategies funded by the US NIH

Characterizing Latent HIV-1 Reservoirs: Our research group is conducting an in-depth analysis of peripheral blood and tissue samples from patients to provide an unprecedented systematic survey of three important factors which influence the magnitude and nature of the HIV reservoir in patients on effective therapy: treatment initiation (during acute versus chronic infection); the pool of follicular dendritic cell-associated virions in lymphoid follicles; and host genetics (CCR-5 Δ32 heterozygosity).

Genetic analysis of unspliced HIV RNA produced during HDAC inhibitor therapy: Despite advances in the treatment of HIV-infected patients, including the complete or near-complete inhibition of viral replication with standard therapies, replication-competent HIV persists indefinitely in all infected individuals. This latent form persists even in persons under effective therapy and can actively and life-threateningly rebound if therapy stops or is taken incorrectly. One promising approach to eradicate HIV and cure infected individuals is to reactivate and target this latent HIV for elimination. During recent clinical trials, latent HIV was reactivated in patients who while on effective therapy were also treated with compounds called histone deacetylaseinhibitors. In conducting this study we are investigating the genetic makeup of this reactivated HIV to determine which cells and tissue compartments are producing this HIV. We anticipate this study will reveal which cells are most prone to HIV reactivation by histone deacetylaseinhibitor therapy. In addition, this study will provide evidence that this reactivated HIV is an important prognostic marker for the latent form of HIV found in cells, an important step in current treatment strategies aimed at eradicating and curing HIV infection.

Longitudinal assessment of the relationship between immune activation and HIV persistence: T cell proliferation, differentiation and activation have poorly defined effects on the latent HIV reservoir during ART. We recently found that the most consistent association correlate of reservoir size is the frequency of memory CD4+ T cells expressing HLA-DR, which is upregulated upon activation. In conducting this project we are measuring the levels of cellular activation markers over time in subjects who have been on ART for 15 years, and determining how these markers predict changes of infection frequency, genetic makeup, and replication competency of HIV in memory T cells. Specifically, we will determine if the inducible reservoir is enriched in cells expressing markers of activation.

The Impact of HBV coinfection on the HIV Reservoir:Approximately 10% of HIV-infected individuals worldwide are co-infected with HBV and co-infected individuals have a 17-fold greater risk of developing liver cancer compared to HBV-mono-infected individuals or 8.4-fold greater risk compared to HIV-mono-infected individuals. Despite the high mortality rates of these co-infections even for patients on therapy, there have been few studies on HBV and HIV co-infections. While studies have shown that HIV exacerbates the natural course of disease progression of HBV by unknown mechanisms, the impact of HBV infection on the natural course of HIV infection is unclear. This study will focus on HIV-HBV co-infections to elucidate whether HBV co-infection has any impact on the HIV replication and reservoir formation.

Delineating the role of turnover rates and T cell activation in maintaining the latent HIV reservoir during effective antiretroviral therapy: This study of cellular mechanisms will investigate whether cellular half-lives affect the level of replication-competent proviruses. Recently, our collaborators at the University of California, San Francisco, Drs. Peter Hunt and Charline Bacchus-Souffan, used established labelling techniques to measure CD4+ T cell turnover based on in vivo incorporation of deuterium into genomic DNA in sort purified HLA-DR negative CD4 T naïve (TN), stem cell memory (TSCM), central memory (TCM), transitional memory (TTM), effector memory (TEM), and effector (TEMRA) cells, after oral administration of deuterated water. In conducting this study they found that the half-life of CD4+ T cell subpopulations decreased significantly with increasing maturation status (p< 0.04). A shorter cellular half-life was associated with higher levels of integrated HIV-1 DNA and cell-associated RNA content (r=0.53, p< 0.0001), with enrichment of virus in shorter lived subpopulations, e.g., TEM, TTM, and TCM (p< 0.019). What remains unclear from this work is whether the virus that is enriched in these shorter-lived populations is replication incompetent and can be “ignored” or whether these more rapidly turning over cell populations harbor replication competent virus that needs to be targeted. In collaboration with Drs. Hunt and Bacchus-Souffan, we will sequence the intact proviruses in sorted memory T cells with known turnover rates and number of HIV-1 integration sites.

Infection and Immunological Conditions
Project titleResearch student
Investigating the Effects of the Tuberculosis (TB)-Associated Microenvironment on HIV Persistence and CD8+ T-Cell-Mediated HIV ClearanceSamantha CRONIN

Publications

Journals

  • Buchholtz, N., Nühn, M., de Jong, T., Stienstra, T., Reddy, K., Ndung’u, T., Ndhlovu, Z., Fisher, K., Palmer, S., Wensing, A., et al (2024). Development of a highly sensitive and specific intact proviral DNA assay for HIV-1 subtype B and C. Virology Journal, 21(1). [More Information]
  • Cronin, S., de Vries-Egan, A., Vahlas, Z., Czernikier, A., Melucci, C., Pereyra Gerber, P., O'Neil, T., Gloss, B., Sharabas, M., Turk, G., Palmer, S., Duette, G., et al (2024). The immunosuppressive tuberculosis-associated microenvironment inhibits viral replication and promotes HIV-1 latency in CD4+ T cells. iScience, 27(7). [More Information]
  • Duette, G., Lee, E., Gomes, G., Tungatt, K., Doyle, C., Stylianou, V., Lee, A., Maddocks, S., Taylor, J., Khanna, R., Sandgren, K., Cunningham, A., Palmer, S., et al (2023). Highly Networked SARS-CoV-2 Peptides Elicit T Cell Responses with Enhanced Specificity. ImmunoHorizons, 7(6), 508-527. [More Information]

2024

  • Buchholtz, N., Nühn, M., de Jong, T., Stienstra, T., Reddy, K., Ndung’u, T., Ndhlovu, Z., Fisher, K., Palmer, S., Wensing, A., et al (2024). Development of a highly sensitive and specific intact proviral DNA assay for HIV-1 subtype B and C. Virology Journal, 21(1). [More Information]
  • Cronin, S., de Vries-Egan, A., Vahlas, Z., Czernikier, A., Melucci, C., Pereyra Gerber, P., O'Neil, T., Gloss, B., Sharabas, M., Turk, G., Palmer, S., Duette, G., et al (2024). The immunosuppressive tuberculosis-associated microenvironment inhibits viral replication and promotes HIV-1 latency in CD4+ T cells. iScience, 27(7). [More Information]

2023

  • Duette, G., Lee, E., Gomes, G., Tungatt, K., Doyle, C., Stylianou, V., Lee, A., Maddocks, S., Taylor, J., Khanna, R., Sandgren, K., Cunningham, A., Palmer, S., et al (2023). Highly Networked SARS-CoV-2 Peptides Elicit T Cell Responses with Enhanced Specificity. ImmunoHorizons, 7(6), 508-527. [More Information]
  • Au, E., Wong, G., Jaure, A., Teixeira-Pinto, A., Van Zwieten, A., Dobrijevic, E., Ahn, C., Blosser, C., Davidson, B., Francis, A., Palmer, S., Scholes-Robertson, N., et al (2023). Scope and Consistency of Cancer Outcomes Reported in Randomized Trials in Kidney Transplant Recipients. Kidney International Reports, 8(2), 274-281. [More Information]
  • Fisher, K., Schlub, T., Boyer, Z., Rasmussen, T., Rhodes, A., Hoh, R., Hecht, F., Deeks, S., Lewin, S., Palmer, S. (2023). Unequal distribution of genetically-intact HIV-1 proviruses in cells expressing the immune checkpoint markers PD-1 and/or CTLA-4. Frontiers in Immunology, 14. [More Information]

2022

  • Rasmussen, T., Ahuja, S., Kuwanda, L., Vjecha, M., Hudson, F., Lal, L., Rhodes, A., Chang, J., Palmer, S., Auberson-Munderi, P., Fisher, K., et al (2022). Antiretroviral Initiation at ≥800 CD4+ Cells/mm3 Associated With Lower Human Immunodeficiency Virus Reservoir Size. Clinical Infectious Diseases, 75(10), 1781-1791. [More Information]
  • Horsburgh, B., Hiener, B., Fisher, K., Lee, E., Morgan, H., Eden, J., von Stockenstrom, S., Odevall, L., Milush, J., Hoh, R., Schlub, T., Palmer, S., et al (2022). Cellular Activation, Differentiation, and Proliferation Influence the Dynamics of Genetically Intact Proviruses over Time. The Journal of Infectious Diseases, 225(7), 1168-1178. [More Information]
  • Suzuki, K., Zaunders, J., Gates, T., Levert, A., Butterly, S., Liu, Z., Ishida, T., Palmer, S., Rae, C., Juge, L., et al (2022). Elevation of cell-associated HIV-1 transcripts in CSF CD4+ T cells, despite effective antiretroviral therapy, is linked to brain injury. Proceedings of the National Academy of Sciences of the United States of America, 119(48). [More Information]

2021

  • Bacchus-Souffan, C., Fitch, M., Palmer, S., Schlub, T., Wang, X., Hiener, B., Horsburgh, B., Fisher, K., Morcilla, V., Hoh, R., et al (2021). HIV-1 Genomes Are Enriched in Memory CD4+ T-Cells with Short Half-Lives. mBio, 12(5), e02447-21. [More Information]
  • García, M., Morcilla, V., Navarrete-Muñoz, M., Fisher, K., Cabello, A., López-Bernaldo, J., De La Hera, F., Barros, C., Fernández-Guerrero, M., Estrada, V., Palmer, S., et al (2021). HIV-DNA content in pTfh cells is associated with residual viremia in elite controllers. AIDS, 35(3), 393-398. [More Information]
  • Cole, B., Lambrechts, L., Gantner, P., Noppe, Y., Bonine, N., Witkowski, W., Chen, L., Palmer, S., Mullins, J., Chomont, N., et al (2021). In-depth single-cell analysis of translation-competent HIV-1 reservoirs identifies cellular sources of plasma viremia. Nature Communications, 12(1), 3727. [More Information]

2020

  • De Scheerder, M., Van Hecke, C., Zetterberg, H., Fuchs, D., De Langhe, N., Rutsaert, S., Vrancken, B., Trypsteen, W., Noppe, Y., Van Der Gucht, B., Palmer, S., et al (2020). Evaluating predictive markers for viral rebound and safety assessment in blood and lumbar fluid during HIV-1 treatment interruption. Journal of Antimicrobial Chemotherapy, 75(5), 1311-1320. [More Information]
  • Horsburgh, B., Lee, E., Hiener, B., Eden, J., Schlub, T., von Stockenstrom, S., Odevall, L., Milush, J., Liegler, T., Sinclair, E., Palmer, S., et al (2020). High levels of genetically intact HIV in HLA-DR+ memory T cells indicates their value for reservoir studies. AIDS, 34(5), 659-668. [More Information]
  • Lee, E., von Stockenstrom, S., Morcilla, V., Odevall, L., Hiener, B., Shao, W., Hartogensis, W., Bacchetti, P., Milush, J., Liegler, T., Palmer, S., et al (2020). Impact of Antiretroviral Therapy Duration on the HIV-1 infection of T-Cells within Anatomic sites. Journal of Virology, 94(3), 1-32. [More Information]

2019

  • Horsburgh, B., Palmer, S. (2019). For Viral Reservoir Studies, Timing Matters. Trends in Microbiology, 27(10), 809-810. [More Information]
  • De Scheerder, M., Vrancken, B., Dellicour, S., Schlub, T., Lee, E., Shao, W., Rutsaert, S., Verhofstede, C., Kerre, T., Malfait, T., Palmer, S., et al (2019). HIV Rebound Is Predominantly Fueled by Genetically Identical Viral Expansions from Diverse Reservoirs. Cell Host and Microbe, 26(3), 347-358.e7. [More Information]
  • Lee, E., Bacchetti, P., Milush, J., Shao, W., Boritz, E., Douek, D., Fromentin, R., Liegler, T., Hoh, R., Deeks, S., Palmer, S., et al (2019). Memory CD4 + T-Cells Expressing HLA-DR Contribute to HIV Persistence During Prolonged Antiretroviral Therapy. Frontiers in Microbiology, 10, 1-19. [More Information]

2018

  • Reeves, D., Duke, E., Wagner, T., Palmer, S., Spivak, A., Schiffer, J. (2018). A majority of HIV persistence during antiretroviral therapy is due to infected cell proliferation. Nature Communications, 9(1), 1-16. [More Information]
  • Hiener, B., Eden, J., Horsburgh, B., Palmer, S. (2018). Amplification of Near Full-length HIV-1 Proviruses for Next-Generation Sequencing. Journal of Visualized Experiments, 140, 1-12. [More Information]
  • Winckelmann, A., Morcilla, V., Shao, W., Schleimann, M., Hojen, J., Schlub, T., Benton, P., Ostergaard, L., Sogaard, O., Tolstrup, M., Palmer, S. (2018). Genetic characterization of the HIV-1 reservoir after Vacc-4x and romidepsin therapy in HIV-1 infected individuals. AIDS, 32(13), 1793-1802. [More Information]

2017

  • Hiener, B., Horsburgh, B., Lee, E., Palmer, S. (2017). A20 The search for replication-competent HIV during effective therapy. Virus Evolution, 3(Suppl 1), 58. [More Information]
  • Hiener, B., Horsburgh, B., Eden, J., Barton, K., Schlub, T., Lee, E., van Stockenstrom, S., Odevall, L., Milush, J., Liegler, T., Palmer, S., et al (2017). Identification of Genetically Intact HIV-1 Proviruses in Specific CD4+ T Cells from Effectively Treated Participants. Cell Reports, 21(3), 813-822. [More Information]
  • Rasmussen, T., McMahon, J., Chang, J., Symons, J., Roche, M., Dantanarayana, A., Okoye, A., Hiener, B., Palmer, S., Lee, W., et al (2017). Impact of alemtuzumab on HIV persistence in an HIV-infected individual on antiretroviral therapy with Sezary syndrome. AIDS, 31(13), 1839-1845. [More Information]

2016

  • Lee, S., Bacchetti, P., Chomont, N., Fromentin, R., Lewin, S., O'Doherty, U., Palmer, S., Richman, D., Siliciano, J., Yukl, S., et al (2016). Anti-HIV antibody responses and the HIV reservoir size during antiretroviral therapy. PloS One, 11(8), 1-13. [More Information]
  • Barton, K., Hiener, B., Winckelmann, A., Rasmussen, T., Shao, W., Byth Wilson, K., Lanfear, R., Solomon, A., McMahon, J., Harrington, S., Palmer, S., et al (2016). Broad activation of latent HIV-1 in vivo. Nature Communications, 7, 1-8. [More Information]
  • Barton, K., Winckelmann, A., Palmer, S. (2016). HIV-1 Reservoirs During Suppressive Therapy. Trends in Microbiology, 24(5), 345-355. [More Information]

2015

  • Procopio, F., Fromentin, R., Kulpa, D., Brehm, J., Bebin, A., Strain, M., Richman, D., O'Doherty, U., Palmer, S., Hecht, F., et al (2015). A Novel Assay to Measure the Magnitude of the Inducible Viral Reservoir in HIV-infected Individuals. EBioMedicine, 2(8), 872-881. [More Information]
  • Wightman, F., Solomon, A., Kumar, S., Urriola, N., Gallagher, K., Hiener, B., Palmer, S., Garsia, R., McNeil, C., Lewin, S. (2015). Effect of ipilimumab on the HIV reservoir in an HIV-infected individual with metastatic melanoma. AIDS, 29(4), 504-506. [More Information]
  • Olesen, R., Vigano, S., Rasmussen, T., Sogaard, O., Ouyang, Z., Buzon, M., Bashirova, A., Carrington, M., Palmer, S., Brinkmann, C., et al (2015). Innate immune activity correlates with CD4 T cell-associated HIV-1 DNA decline during latency-reversing treatment with panobinostat. Journal of Virology, 89(20), 10176-10189. [More Information]

2014

  • Markowitz, M., Evering, T., Garmon, D., Caskey, M., La Mar, M., Rodriguez, K., Sahi, V., Palmer, S., Prada, N., Mohri, H. (2014). A Randomized Open-Label Study of 3- Versus 5-Drug Combination Antiretroviral Therapy in Newly HIV-1–Infected Individuals. JAIDS: Journal of Acquired Immune Deficiency Syndromes, 66(2), 140-147. [More Information]
  • Elliott, J., Wightman, F., Solomon, A., Ghneim, K., Ahlers, J., Cameron, M., Smith, M., Spelman, T., McMahon, J., Velayudham, P., Palmer, S., et al (2014). Activation of HIV Transcription with Short-Course Vorinostat in HIV-Infected Patients on Suppressive Antiretroviral Therapy. PLoS Pathogens, 10(11), 1-19. [More Information]
  • Dahl, V., Gissle´n, M., Hagberg, L., Peterson, J., Shao, W., Spudich, S., Price, R., Palmer, S. (2014). An example of genetically distinct HIV type 1 variants in cerebrospinal fluid and plasma during suppressive therapy. The Journal of Infectious Diseases, 209(10), 1618-1622. [More Information]

2013

  • Hatano, H., Yukl, S., Ferre, A., Graf, E., Somsouk, M., Sinclair, E., Abdel-Mohsen, M., Liegler, T., Harvill, K., Hoh, R., Palmer, S., et al (2013). Prospective Antiretroviral Treatment of Asymptomatic, HIV-1 Infected Controllers. PLoS Pathogens, 9(10), 1-13. [More Information]
  • Josefsson, L., Palmer, S., Faria, N., Lemey, P., Casazza, J., Ambrozak, D., Kearney, M., Shao, W., Kottilil, S., Sneller, M., et al (2013). Single cell analysis of lymph node tissue from HIV-1 infected patients reveals that the majority of CD4+ T-cells contain one HIV-1 DNA molecule. PLoS Pathogens, 9(6), 1-12. [More Information]
  • Josefsson, L., von Stockenstrom, S., Faria, N., Sinclair, E., Bacchetti, P., Killian, M., Epling, L., Tan, A., Ho, T., Lemey, P., Palmer, S., et al (2013). The HIV-1 reservoir in eight patients on long-term suppressive antiretroviral therapy is stable with few genetic changes over time. Proceedings of the National Academy of Sciences of the United States of America, 110(51), E4987-E4996. [More Information]

Selected Grants

2024

  • Delineating the viro-immunological factors contributing to transient HIV control during consecutive analytical treatment interruptions, Palmer S, Lee E, Duette G, National Institutes of Health (USA)/Research Grant

2022

  • Combining immunogenic peptides and Nef blockade to enhance CD8 T-cell-mediated clearance of HIV-infected cells, Palmer S, Lee E, Duette G, National Institutes of Health (USA)/Research Grant

In the media

Sheridon, Kate. “HIV Cure: New way to find hidden cells brings scientists one step closer.” 19 Oct. 2017, www.newsweek.com/hiv-cure-new-way-find-hidden-cells-brings-scientists-closer-688532