In the global effort to cure HIV, one of the biggest scientific barriers is locating the virus’s reservoirs — hidden sites in the body where HIV can lie dormant, invisible to antiretroviral therapy (ART). The Last Gift Study, conducted by UC San Diego and collaborators, offers a novel way forward.
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‘As a long-term survivor, I care deeply about the HIV community, and I am thankful for the opportunity to participate and provide this Last Gift to my people.’ Tony Bennett (above, surrounded by his partner Blake and a cousin) was the first to take part in The Last Gift.
In the global effort to cure HIV, one of the biggest scientific barriers is locating the virus’s reservoirs — hidden sites in the body where HIV can lie dormant, invisible to antiretroviral therapy (ART). The Last Gift Study, conducted by UC San Diego and collaborators, offers a novel way forward. Terminally ill people living with HIV consent to rapid autopsies within hours of their death, allowing researchers to map in unprecedented detail where HIV hides.
The study has conducted 42 rapid autopsies so far. These autopsies allow scientists to sample various tissues soon after death, before decomposition obscures anatomical details or viral localization. Researchers have identified HIV reservoirs in jejunum, lymph nodes, the male genital tract, among other places.
Heat diagram of the body organs with the relative abundances of HIV virions. Red compartments (stomach, intestines, lymph nodes) indicate higher levels of HIV, while orange compartments (liver, brain, and kidney) have less viral load.
Participants are usually on ART before death. The data allow comparison between what ART suppresses in the living and what is still detectable in tissues post-mortem.
Testimonies from participants show powerful motivations: altruism, leaving a legacy, belief in scientific progress. For example, in Positively Aware, a participant “My death will not be in vain. It will allow me to leave a positive legacy and inspire others to give back.” (positivelyaware.com)
So far, the study is offering insights that are otherwise nearly impossible — especially about HIV reservoirs in less accessible tissues (brain, gut, lymphoid tissue, genital tract). These insights are crucial for designing cure strategies that truly address latent virus, not just what’s visible in blood.
Ethical and Social Concerns
Despite its scientific promise, the Last Gift Study raises several ethical questions:
Consent around end of life: Are people who are terminally ill fully able to understand and consent to what donating their body will entail, especially the autopsy within hours after death? Critics argue that emotional state, pain, grief, or diminished capacity may interfere.
Translatability: Even if HIV reservoirs are mapped, will that lead to therapies that can reach them safely, or in all populations?
Community engagement and oversight: The study has a community advisory board, which helps ensure the voices of people with HIV are included. But vigilance is needed to maintain transparency.
Body donation is a sensitive topic. Public and media reports in recent years have exposed abuses and misuses in the world of body (cadaver) donation, which risk undermining trust. A few examples:
Reuters reported how Science Care, a U.S. company, earned over $27 million annually recruiting body donors “through hospices, clergy and online ads,” and then selling or distributing body parts for profit. For many donors or next of kin, the possibility that donated bodies are being used in profit-making operations is very disturbing.
When people hesitate to donate their body for science — whether because of religious beliefs, cultural taboos, fear of misuse, or simply distrust — studies like Last Gift may find it harder to enroll participants. This could slow or even stall progress in cure research.
Green Prophet Past Coverage & Related Concerns
Green Prophet has covered similar issues of medical ethics, public health, and trust in science. Some previous articles that readers may consult:
AIDS from Baby Gaga breast-milk ice cream?
AIDS cured with Egypt’s magical “kebab” machine, army claims video — unpacking false “miracle cures” and the danger of misinformation.
The post HIV donors give their bodies in a new science
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