HIV/AIDS Research at NCI: A Record of Sustained Excellence
The human immunodeficiency virus (HIV) and the disease it causes, Acquired Immune Deficiency Syndrome (AIDS), announced itself in the United States in 1981, in the form of a small, sudden uptick in reports of a rare cancer, Kaposi sarcoma (KS), and a rare form of pneumonia among young gay men in New York and San Francisco. That same year, in the NIH Clinical Center, NCI physicians treated the first patient with this deadly, yet-to-be-named disease.
NCI's history will forever be intertwined with that of HIV and AIDS. NCI scientists were at the forefront of the effort to identify HIV as the cause of AIDS, characterize how it hijacked cellular machinery, and, in turn, develop the first treatments for it.
Last week, NCI and its Center for Cancer Research (CCR) hosted a symposium on NCI's role in HIV/AIDS research, during which four current and former NCI scientists - Drs. Robert Gallo, Samuel Broder, Robert Yarchoan, and Hiroaki “Mitch” Mitsuya - were honored for their pioneering work in response to this threat to global public health.
Dr. Gallo was chief of the NCI Laboratory of Tumor Cell Biology when it became apparent that the disease we would soon call AIDS was a grave public health issue. The research on human retroviruses by Dr. Gallo and his team - they discovered the first two such viruses, HTLV-1 and -2 - laid the groundwork for the co-discovery of HIV in 1984.
Dr. Gallo's lab also led the development of a blood test for HIV, meaning donated blood could be effectively screened for the virus. With others at NCI, Dr. Gallo was instrumental in developing the first treatments for HIV.
Dr. Broder, who later served as NCI director for 6 years; Dr. Mitsuya; and Dr. Yarchoan led the initial development and clinical trials of the first effective treatments for HIV. That includes AZT, a drug originally developed to treat cancer that they found could inhibit HIV replication.
The trio also led the development of two other anti-HIV drugs, didanosine (ddI) and zalcitabine (ddC), which, with AZT, were the first FDA-approved treatments for AIDS and which continue to be the cornerstone of the HAART regimen that has transformed HIV infection into a chronic disease.
What these four scientists helped to launch 26 years ago is now one of the most well-respected HIV/AIDS research programs in the world. Indeed, NCI researchers in CCR's HIV and AIDS Malignancy Branch, the HIV DRP Host Virus Interaction Branch, and Vaccine Branch are building on their historic achievements.
Among these are the identification of genetic mutations that appear to protect against HIV infection or slow its progression, new insights into HIV viral diversity that contributes to drug resistance, and the development of new treatments for AIDS-related cancers, including KS and lymphoma. NCI researchers also are at the forefront of efforts to develop both preventive and therapeutic HIV vaccines and new treatments derived from natural products.
These efforts at NCI continue now in partnership with others. Our efforts today are becoming even more important to our cancer agenda, as we can now refer to this virus as yet another cancer-causing infectious agent - not just regarding the AIDS virus-associated cancers, but now in terms of the striking increase in the incidence of all epithelial malignancies in chronically infected patients.
To ensure NCI's efforts are integrated and to foster collaboration with other NIH institutes and external partners in academia and industry, a new Center of Excellence in HIV/AIDS & Cancer Virology has been established.
The cancer community should be proud that NCI continues to expand upon the legacy of early HIV/AIDS research led by Drs. Gallo, Broder, Yarchoan, and Mitsuya. AIDS has killed more than 25 million people worldwide. Many more would have died without the efforts of these scientists and their colleagues. If their history has demonstrated anything, it's that progress can be made even in the face of the most severe challenges.
Dr. John E. Niederhuber