2.0 Michael Gottlieb — Introduction to Session 2

Michael Gottlieb: [00:00:00] My thanks to the organizers and my co-chair for conceiving the idea for this meeting. Bruce [Walker] has allowed me three minutes to say something at the start of this as a chair. It's a pleasure to see many of you who I know, and also to meet for the first time many of you who I know from your work and from the literature. Also to hear about what we heard last evening about the context of [00:00:30] HIV virology and the context of RNA tumor viruses over the years.

My story, very quickly, about the first patients is that in early 1981 at the UCLA Medical Center, we saw several unusual cases in young men, Pneumocystis pneumonia and other opportunistic infections. These illnesses were traumatic. That top slide is the MMWR from June 5th, 1981. (1) The cases [00:01:00] were dramatic and we saw them in rapid sequence and we were able to put it together. This was published in MMWR. We collaborated with CDC's EIS (Epidemic Intelligence Service) Officer in Los Angeles to make this report. These first patients certainly made an impression on all of us such that I remember their names. I remember what they looked like. I remember them in greater detail than patients I saw last week. 

[00:01:30] Later that year, the second slide there, we published in the New England Journal of Medicine (2) and there were two other papers, one from Fred Siegal at Mount Sinai (3) and one from Henry Masur (4). In our own paper, we raised the question of whether there might be a virus involved and we picked on a DNA virus, CMV (cytomegalovirus), which turned out to be secondary to the immune deficiency. Of course, the infections we saw were associated with immunosuppression [00:02:00] and the near absence of CD4 cells. You can see on the bottom panel of an original Kodachrome slide.

The near absence of CD4 cells and was discovered in the laboratory of the late John Fahey (1924–2014), at UCLA. He had an NIAID (National Institute of Allergy and Infectious Diseases) program project called CIRID, the Center for Interdisciplinary Research in Immunologic Diseases. The timing was perfect for its involvement in the HIV [00:02:30] epidemic. Our first patients died within the first year. I had naively thought that it might be possible for their immune deficiency to recover. There was a great deal of mystery and fear as reflected in the headlines from the era.

Remarkably, the etiology of all this was found just two years after the description of the clinical syndrome [00:03:00], and that was through the work of Françoise [Barré-Sinoussi] and Bob [Gallo] and Jean-Claude Chermann (b. 1939) and Jay Levy (b. 1938). This is a slide from Francoise's paper (4), which you're going to see and hear about in just a bit, showing the spike in reverse transcript days activity at the lower left in her cultures. That's the beginning of the story as far as my early involvement. I will now welcome my good [00:03:30] friend and close colleague Paul Volberding to talk about his first patients.

[00:03:36] [END OF AUDIO]

Citations

1. Gottlieb, Michael S., Howard M. Schanker, Peng Thim Fan, Andrew Saxon, Joel D. Weisman, and I. Pozalski. “Pneumocystis Pneumonia—Los Angeles.” MMWR Morbidity and Mortality Weekly Report 30, no. 21 (June 5, 1981): 250–52. https://stacks.cdc.gov/view/cdc/1261/

2. Gottlieb, Michael S., Robert Schroff, Howard M. Schanker, Joel D. Weisman, Peng Thim Fan, Robert A. Wolf, and Andrew Saxon. “Pneumocystis Carinii Pneumonia and Mucosal Candidiasis in Previously Healthy Homosexual Men.” New England Journal of Medicine 305, no. 24 (December 10, 1981): 1425–31. doi:10.1056/NEJM198112103052401.

3. Siegal, Frederick P., Carlos Lopez, Glenn S. Hammer, Arthur E. Brown, Stephen J. Kornfeld, Jonathan Gold, Joseph Hassett, et al. “Severe Acquired Immunodeficiency in Male Homosexuals, Manifested by Chronic Perianal Ulcerative Herpes Simplex Lesions.” New England Journal of Medicine 305, no. 24 (December 10, 1981): 1439–44. doi:10.1056/NEJM198112103052403.

4. Barré-Sinoussi, Françoise, Jean-Claude Chermann, Françoise Rey, Marie-Thérèse Nugeyre, Sophie Chamaret, Jacqueline Gruest, Charles Dauguet, et al. “Isolation of a T-Lymphotropic Retrovirus from a Patient at Risk for Acquired Immune Deficiency Syndrome (AIDS).” Science 220, no. 4599 (May 20, 1983): 868–71. doi:10.1126/science.6189183.

Index

• 2.1 Paul Volberding — The First Patients 
• 2.4 Robert "Bob" Gallo — Discoveries of Human Retrovirus, Their Linkage to Disease as Causative Agents & Preparation for the Future 
• 2.5 Françoise Barré-Sinoussi — Discovery of HIV 
• 6.3 Bruce Walker — Role of T Cells in Controlling HIV Infection 
• Center for Interdisciplinary Research in Immunology and Disease (CIRID, 1978–1998) 
• Chermann, Jean-Claude (b. 1939) 
• cytomegalovirus (CMV) 
• Epidemic Intelligence Service (EIS) 
• Fahey, John L. (1924–2014) 
• fear 
• immunosuppression, immunosuppressive drugs 
• Levy, Jay A. (b. 1938) 
• Los Angeles, California 
• Masur, Henry 
• memory 
• MMWR Morbidity and Mortality Weekly Report 
• Mount Sinai Hospital, New York 
• National Institute of Allergy and Infectious Diseases (NIAID) 
• New England Journal of Medicine (NEJM) 
• Pneumocystis pneumonia (PCP) 
• retrovirus classification, subfamilies, and genera 
• Siegal, Frederick 
• UCLA (University of California, Los Angeles), UCLA School of Medicine, UCLA Medical Center