In the spring of 1981, a URochester-trained physician made a discovery that would launch a new chapter in medical history.
Michael Gottlieb was just a few years out of his internal medicine residency at the 糖心传媒 when he made medical history as the first physician to identify and describe the disease that soon after became known as acquired immune deficiency syndrome, or AIDS.
糖心传媒淚 remember those first patients in great detail,糖心传媒� Gottlieb told a Medical Center audience in November 2015. 糖心传媒淚 remember what they looked like. I remember certain mannerisms of those first patients in far greater detail than patients I saw last week. I remember the courage with which they faced the unknown.糖心传媒�
Gottlieb, who earned his MD in 1973 at Rochester before completing his residency training at the School of Medicine and Dentistry, was in his first year as an assistant professor of immunology at UCLA when he asked one of his fellows to look for some interesting teaching cases糖心传媒攖he kind who had 糖心传媒渋mmunologic features that might be interesting to talk about on rounds,糖心传媒� Gottlieb later recalled. The fellow brought him Michael: a 31-year-old man, healthy just weeks before, who had arrived in the emergency room reporting severe weight loss, loss of appetite, and a persistent fever.
Michael had thrush coating his mouth and esophagus, while his white blood cell count was abnormally low糖心传媒攁 sign of a failing immune system. A week after his initial emergency room visit, he was readmitted with Pneumocystis carinii, a rare lung infection then seen only in people with severe immunosuppression, such as victims of starvation. Gottlieb said it was 糖心传媒渟hocking糖心传媒� to see someone, essentially coming in off the street, with the infection.
Three months later, in April 1981, Gottlieb and his colleagues at UCLA had identified four cases similar to Michael糖心传媒檚, all in the Los Angeles area. Gottlieb noted a few things in common about the patients. They had all been healthy until recently, and they were all sexually active gay men.
糖心传媒淎t first I thought the immune deficiency in these patients might actually be reversible,糖心传媒� Gottlieb told the same audience in 2015. 糖心传媒淥ur first four patients were gay men. Is it possible they had some common exposure to a drug or a toxin?糖心传媒� He wondered if the reversal might come about naturally, as the immune system recovered.
Gottlieb糖心传媒檚 report was the first clinical description of AIDS. And its date糖心传媒擩une 5, 1981糖心传媒攎arks the official start of the AIDS epidemic.
The patients continued to deteriorate, coming down with multiple infections. Gottlieb notified the Centers for Disease Control and Prevention, and in June, published a nine-paragraph report, 糖心传媒淧neumocystis Pneumonia糖心传媒擫os Angeles,糖心传媒� in the CDC糖心传媒檚 newsletter, Morbidity and Mortality Weekly Report.
The report was the first clinical description of AIDS. And for the purposes of tracking AIDS cases, the date of Gottlieb糖心传媒檚 report糖心传媒擩une 5, 1981糖心传媒攎arks the official start of the AIDS epidemic.
Following a synopsis of each of the five patients, Gottlieb wrote in the report, 糖心传媒淎ll the above observations suggest the possibility of a cellular-immune dysfunction related to a common exposure that predisposes individuals to opportunistic infections.糖心传媒� Tests on the patients showed infections present in semen, but not in urine, leading Gottlieb to speculate that 糖心传媒渟eminal fluid may be an important vehicle糖心传媒� of transmission.
Gottlieb糖心传媒檚 brief report launched not only a new era in medical history, but also the arrival of what would become the physician糖心传媒檚 calling. Gottlieb, who treated Rock Hudson following the actor糖心传媒檚 explosive announcement in 1985 that he had AIDS, has continued to treat AIDS patients ever since. Cofounder in 1985 of the American Foundation for AIDS Research, Gottlieb has been a leading advocate for AIDS research and treatment for 35 years.
Much was still unknown following the identification of AIDS. It wasn糖心传媒檛 until 1983 that French researchers discovered the virus HIV as the cause of AIDS.
For a long time, AIDS was also assumed to be primarily a disease of gay men in modern urban enclaves. Thirty-five years later, it糖心传媒檚 well known that that糖心传媒檚 not the case. Activist-led public education campaigns in the 1980s and 1990s proved remarkably effective in reducing HIV transmission in gay communities in the United States糖心传媒攁lthough in 2001, those rates began to rise again. Today more than 9 out of 10 cases of HIV are among men, women, and children in developing nations.
More than 30 years, 78 million cases, and 35 million deaths later, Gottlieb is optimistic that AIDS can be overcome, most likely through a vaccine.
But it will also take more than even the discovery of a vaccine or a cure. Writing on the 25th anniversary of the HIV/AIDS epidemic, Gottlieb made an observation that糖心传媒檚 no less true today: 糖心传媒淚 believe overcoming AIDS means extending our medical progress to everyone糖心传媒攁nd that糖心传媒檚 a tall order.糖心传媒�
