From the Annals of NIH History

AIDS at 35

The NIH Played a Major Role in Discovering the AIDS Virus

BY MICHAEL GOTTESMAN, OD

Sometime in the early 1970s, or perhaps even earlier, a virus capable of severely compromising the human immune system made its way from central Africa to the United States via Haiti. With a long incubation period before symptoms appeared, and with limited incidence of infections, the virus was on no one’s radar screen. But that situation changed dramatically on June 5, 1981, when the Centers for Disease Control and Prevention (CDC) published a report in its Morbidity and Mortality Report newsletter about a mysterious cluster of Pneumocystis pneumonia (PCP) in five homosexual men in Los Angeles.

Although the public wouldn’t be aware of the burgeoning epidemic for a few more years, public-health experts—including those at the NIH—were both intrigued and concerned by the report. “The patients did not know each other and had no known common contacts or knowledge of sexual partners who had had similar illnesses,” the report stated. “Three patients had profoundly depressed in vitro proliferative responses to mitogens and antigens.”

And so the mystery began. Over the next 18 months, health experts discovered more PCP clustering and cases of Kaposi’s sarcoma among gay men in California cities, giving rise to the term gay-related immune deficiency, or GRID. Yet this GRID syndrome was also seen in heroin users, people with hemophilia, and people from Haiti, leading some researchers to use the term “4H disease.” It wasn’t until July 1982 that the CDC coined the name that would stick, acquired immune deficiency syndrome (AIDS).

The NIH played a major role in identifying the virus in the early 1980s. The first “AIDS” patient came to the NIH Clinical Center in 1981, before anyone knew what the disease was. In 1986, Bob Gallo (National Institute of Allergy and Infectious Diseases, NIAID) would earn his second Lasker award for determining that human immunodeficiency virus type 1 (HIV-1) causes most cases of AIDS.

The NIH developed the first blood tests to detect HIV, too. A wonderful telling of these early events is captured in a virtual exhibit and collection of oral histories titled “In Their Own Words: NIH Researchers Recall the Early Years of AIDS,” created by the Office of NIH History in the 1990s.

What’s hinted at in these oral histories, collected between 1988 and 1993, is the cocktail of treatments developed in the 1990s that would transform AIDS from a death sentence into a manageable chronic disease, at least in wealthier countries. The NIH intramural program has been instrumental in developing these therapies.

On June 15, 2016, as part of the Clinical Center Grand Rounds series, NIAID Director Anthony Fauci delivered a talk titled “AIDS at 35: Is the End in Sight?” (http://videocast.nih.gov/launch.asp?19752). Fauci is perhaps the most knowledgeable person on Earth when it comes to AIDS, both its history and its pathology. His talk was an enlightening overview of an epidemic for which much work still needs to be done. NIAID has created a Twitter hashtag, #35YearsOfAIDS, for those of you interested in sharing information or your thoughts on AIDS and its history (https://mobile.twitter.com/search?q=35YearsOfAIDS).

The NIH is making history today with its work on Ebola and Zika, and its past successes and experiences, both good and bad, can guide us here. This is one of the reasons why capturing and remembering our history is so important.