BALTIMORE — Before AIDS got its name, it was a mystery disease, killing mostly young, homosexual men in a horrible way — and no one knew why.
In 1982, the disease got a name: acquired immune deficiency syndrome. And on April 23, 1984, researchers at NIH’s National Cancer Institute, led by Dr. Robert Gallo, announced they had found the cause.
“Thirty years; it makes me feel so young,” the 76-year-old said with a chuckle as he reflected on all that has happened in the battle against AIDS.
When the first AIDS cases began making headlines, Gallo was working on a retrovirus linked to a form of leukemia. Another doctor, James Curran, then the head of the AIDS program at the Centers for Disease Control, urged Gallo to get involved. Curran kept pushing, and Gallo says he started to notice similarities between patients with the leukemia retrovirus HTLV1 and those with AIDS.
“I thought we might want to get involved in this, that this virus might be similar to the one we are working on,” he recalls. He took the challenge, perhaps a bit unwillingly at first, with a new retrovirus as the prime suspect in the AIDS mystery.
He tapped his leukemia research for clues and techniques. But this was a medical and scientific hunt very different from any he had embarked on before. There would be no retreating to the lab, focusing on the pure science.
“AIDS became unusual in the sense that the patients were more in our face,” he says.
And it wasn’t just the AIDS activists, who fought hard to keep their cause in front of the medical community. Gallo says it seems everyone knew someone suffering from the disease. “You saw them; you met them — it was too fast, too many.”
There was no Eureka moment in the search for the AIDS virus. There were times of elation when they developed the first cell lines — or permanent cell cultures — or were able to identify random samples sent by the CDC.
But mostly, the hunt for the cause of AIDS evolved slowly, painstakingly, in the lab. First came the identification of the AIDS virus, then the first reliable and inexpensive blood test, and in time the pharmaceutical industry produced a series of ever-improving treatments.
The search for a full cure and a vaccine continue, but has proven perhaps far more difficult due to the unique nature of the AIDS retrovirus.
“I think the notion of a total virological cure, where you can say ‘these people don’t have a single virus particle left in their body’ — I think that is a fantasy,” says Gallo.
Instead, he points to the possibility of what he calls a “functional cure,” where patients with HIV can no longer transmit the virus and no longer need medication.
As for a vaccine, Gallo says, “as usual, HIV presents enormous challenges, and this one is super-enormous.”
He says most of the clinical vaccine trials have been failures, or, at best, inconclusive. One candidate is now being examined at the Institute of Human Virology, but the antibodies it creates do not last.
Gallo says it is a “basic science problem,” and he worries that people will get tired of funding the research. Still, he says he is hopeful about the prospect that someone will eventually create a vaccine that produces long-lasting antibodies.
“I can’t be 100 percent sure it is solvable, but I think so,” he says. “I have to believe so. We have a lot invested in it and I think we have to try.”