Christopher Pilcher

Professor Emeritus

Dr. Christopher D. Pilcher is Professor in the Department of Medicine, Division of HIV, Infectious Diseases and Global Medicine, at UCSF and Zuckerberg SF General Hospital. He trained at the University of Vermont, Duke University and the University of North Carolina at Chapel Hill; he is board certified in Internal Medicine, Pediatrics and Infectious Diseases, and has been caring for adults with HIV infection since 1993.
As a research scientist, Dr. Pilcher has authored over a hundred scholarly articles, book chapters and commentaries. He is a recognized authority on using infectious disease diagnostic tests for clinical decision making and surveillance of incidence. His work has focused on diagnosis of acute HIV infection; the same-day initiation of antiretroviral treatment; and the biology of infectivity in both acute and chronic HIV infection.
Dr. Pilcher developed and led cohort studies in the US, Malawi and Brazil to facilitate clinical research, and most recently worked to develop the international CEPHIA 2 cohort for incidence test evaluation. In work with public health programs in North Carolina he developed the STAT program for acute HIV testing and immediate treatment; from 2012 in San Francisco he led the UCSF Options cohort, and in 2013 he began the RAPID program for same-day antiretroviral treatment at Zuckerberg SF General Hospital.
Dr. Pilcher retired in 2019 but remains actively engaged in clinical research.
Education
Fellowship, 2000 - Infectious Diseases, University of North Carolina at Chapel Hill
Residency, 1997 - Internal Medicine and Pediatrics, Duke University Medical Center
Senior House Officer, 1996 - Paediatrics, Oxford University John Radcliffe Hospital
MD, 1993 - Medicine, University of Vermont College of Medicine
AB, 1986 - Biology, Harvard University
Publications
  1. Group Testing for Sars-Cov-2 to Enable Rapid Scale-Up of Testing and Real-Time Surveillance of Incidence.
  2. Seminal plasma-derived extracellular vesicle fractions from HIV-infected men exhibit unique miRNA signatures and induce a pro-inflammatory response in cells isolated from the female reproductive tract.
  3. Semen virome of men with HIV on or off antiretroviral treatment.
  4. Seminal plasma promotes decidualization of endometrial stromal fibroblasts in vitro from women with and without inflammatory disorders in a manner dependent on interleukin-11 signaling.
  5. Clinical and Immunologic Outcomes after Immediate or Deferred Antiretroviral Therapy Initiation during Primary HIV Infection: The Sabes Randomized Clinical Study.
  6. Interpreting HIV diagnostic histories into infection time estimates: analytical framework and online tool.
  7. Some Aspects of CD8+ T-Cell Exhaustion Are Associated With Altered T-Cell Mitochondrial Features and ROS Content in HIV Infection.
  8. Performance comparison of the Maxim and Sedia Limiting Antigen Avidity assays for HIV incidence surveillance.
  9. Challenges to the performance of current HIV diagnostic assays and the need for centralized specimen archives: a review of the Consortium for the Evaluation and Performance of HIV Incidence Assays (CEPHIA) repository.
  10. A generalizable method for estimating duration of HIV infections using clinical testing history and HIV test results.
  11. RAPID antiretroviral therapy: high virologic suppression rates with immediate antiretroviral therapy initiation in a vulnerable urban clinic population.
  12. Computational analysis of antibody dynamics identifies recent HIV-1 infection.
  13. Infection Staging and Incidence Surveillance Applications of High Dynamic Range Diagnostic Immuno-Assay Platforms.
  14. Anti-HERV-K (HML-2) capsid antibody responses in HIV elite controllers.
  15. HIV Antibody Level as a Marker of HIV Persistence and Low-Level Viral Replication.
  16. Clinical and public health implications of acute and early HIV detection and treatment: a scoping review.
  17. Semen amyloids participate in spermatozoa selection and clearance.
  18. Early and Delayed Antiretroviral Therapy Results in Comparable Reductions in CD8+ T Cell Exhaustion Marker Expression.
  19. Real-world performance of the new US HIV testing algorithm in medical settings.
  20. Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma.
  21. The Effect of Same-Day Observed Initiation of Antiretroviral Therapy on HIV Viral Load and Treatment Outcomes in a US Public Health Setting.
  22. Performance of the Bio-Rad Geenius HIV1/2 Supplemental Assay in Detecting "Recent" HIV Infection and Calculating Population Incidence.
  23. Viral load criteria and threshold optimization to improve HIV incidence assay characteristics.
  24. Editorial Commentary: Timing Is Everything: Shortcomings of Current HIV Diagnostics in the Early Treatment Era.
  25. Selection of a potential diagnostic biomarker for HIV infection from a random library of non-biological synthetic peptoid oligomers.
  26. Efficient Identification of HIV Serodiscordant Couples by Existing HIV Testing Programs in South Brazil.
  27. Gut-Resident Lactobacillus Abundance Associates with IDO1 Inhibition and Th17 Dynamics in SIV-Infected Macaques.
  28. Newly Exerted T Cell Pressures on Mutated Epitopes following Transmission Help Maintain Consensus HIV-1 Sequences.
  29. Longitudinal Genetic Characterization Reveals That Cell Proliferation Maintains a Persistent HIV Type 1 DNA Pool During Effective HIV Therapy.
  30. Select host restriction factors are associated with HIV persistence during antiretroviral therapy.
  31. How can we better identify early HIV infections?
  32. High Transmissibility During Early HIV Infection Among Men Who Have Sex With Men-San Francisco, California.
  33. Independent assessment of candidate HIV incidence assays on specimens in the CEPHIA repository.
  34. Programmed death-1 expression on CD4? and CD8? T cells in treated and untreated HIV disease.
  35. Dynamic regulation of host restriction factor expression over the course of HIV-1 infection in vivo.
  36. Decreased HIV type 1 transcription in CCR5-?32 heterozygotes during suppressive antiretroviral therapy.
  37. Longitudinal characterization of depression and mood states beginning in primary HIV infection.
  38. Direct visualization of HIV-enhancing endogenous amyloid fibrils in human semen.
  39. Toward an endgame: finding and engaging people unaware of their HIV-1 infection in treatment and prevention.
  40. Trans-activation, post-transcriptional maturation, and induction of antibodies to HERV-K (HML-2) envelope transmembrane protein in HIV-1 infection.
  41. Performance of rapid point-of-care and laboratory tests for acute and established HIV infection in San Francisco.
  42. HIV-1 Vif adaptation to human APOBEC3H haplotypes.
  43. Activation associated ERK1/2 signaling impairments in CD8+ T cells co-localize with blunted polyclonal and HIV-1 specific effector functions in early untreated HIV-1 infection.
  44. HIV-associated disruption of mucosal epithelium facilitates paracellular penetration by human papillomavirus.
  45. Antiretroviral therapy initiated within 6 months of HIV infection is associated with lower T-cell activation and smaller HIV reservoir size.
  46. Challenges in detecting HIV persistence during potentially curative interventions: a study of the Berlin patient.
  47. T cells target APOBEC3 proteins in human immunodeficiency virus type 1-infected humans and simian immunodeficiency virus-infected Indian rhesus macaques.
  48. Changes in seroadaptive practices from before to after diagnosis of recent HIV infection among men who have sex with men.
  49. Seroadaptive practices: association with HIV acquisition among HIV-negative men who have sex with men.
  50. Influence of HAART on alternative reading frame immune responses over the course of HIV-1 infection.
  51. Adjusting for sampling variability in sparse data: geostatistical approaches to disease mapping.
  52. Identifying the early post-HIV antibody seroconversion period.
  53. Sexual partnership patterns in malawi: implications for HIV/STI transmission.
  54. Differential persistence of transmitted HIV-1 drug resistance mutation classes.
  55. Transmitted drug resistance in persons with acute/early HIV-1 in San Francisco, 2002-2009.
  56. Beyond detuning: 10 years of progress and new challenges in the development and application of assays for HIV incidence estimation.
  57. Oral cyclosporin A inhibits CD4 T cell P-glycoprotein activity in HIV-infected adults initiating treatment with nucleoside reverse transcriptase inhibitors.
  58. Sexually transmitted infections among patients with acute HIV in North Carolina.
  59. Targeted testing for acute HIV infection in North Carolina.
  60. Transmitted antiretroviral drug resistance among acute and recent HIV infections in North Carolina from 1998 to 2007.
  61. The deadliest catch: fishing for HIV in new waters.
  62. Optimizing screening for acute human immunodeficiency virus infection with pooled nucleic acid amplification tests.
  63. Inferring HIV transmission dynamics from phylogenetic sequence relationships.
  64. Clinical presentation and diagnosis of primary HIV-1 infection.
  65. Frequent detection of acute HIV infection in pregnant women.
  66. Improved detection of acute HIV-1 infection in sub-Saharan Africa: development of a risk score algorithm.
  67. Amplified transmission of HIV-1: comparison of HIV-1 concentrations in semen and blood during acute and chronic infection.
  68. Comparison of group testing algorithms for case identification in the presence of test error.
  69. Intensification of a triple-nucleoside regimen with tenofovir or efavirenz in HIV-1-infected patients with virological suppression.
  70. Diagnosis and management of acute HIV infection.
  71. Detection of acute HIV infections in an urban HIV counseling and testing population in the United States.
  72. Lessons from primary HIV infection.
  73. Rapid, real-time detection of acute HIV infection in patients in Africa.
  74. Acute HIV revisited: new opportunities for treatment and prevention.
  75. A randomized, partially blinded phase 2 trial of antiretroviral therapy, HIV-specific immunizations, and interleukin-2 cycles to promote efficient control of viral replication (ACTG A5024).
  76. Approaching "HIV elimination": interventions for acute HIV infection.
  77. Three- vs four-drug antiretroviral regimens for the initial treatment of HIV-1 infection: a randomized controlled trial.
  78. Amplified HIV Transmission: The Missing Link in the HIV Pandemic?.
  79. Detection of acute infections during HIV testing in North Carolina.
  80. Surveillance for HIV-1 incidence using tests for recent infection in resource-constrained countries.
  81. The unexpected movement of the HIV epidemic in the Southeastern United States: transmission among college students.
  82. Amplified HIV transmission and new approaches to HIV prevention.
  83. Multiple V1/V2 env variants are frequently present during primary infection with human immunodeficiency virus type 1.
  84. Triple-nucleoside regimens versus efavirenz-containing regimens for the initial treatment of HIV-1 infection.
  85. Brief but efficient: acute HIV infection and the sexual transmission of HIV.
  86. Acute HIV revisited: new opportunities for treatment and prevention.
  87. Absence of sustained hyperlactatemia in HIV-infected patients with risk factors for mitochondrial toxicity.
  88. HIV infection: point-of-care testing.
  89. Frequent detection of acute primary HIV infection in men in Malawi.
  90. Envelope diversity, coreceptor usage and syncytium-inducing phenotype of HIV-1 variants in saliva and blood during primary infection.
  91. Infrequent diagnosis of primary human immunodeficiency virus infection: missed opportunities in acute care settings.
  92. Real-time, universal screening for acute HIV infection in a routine HIV counseling and testing population.
  93. Diagnosing primary HIV infection.
  94. HIV antigens can induce TGF-beta(1)-producing immunoregulatory CD8+ T cells.