June 5, 2021, will mark 40 years since Los Angeles physician Dr. Michael Gottlieb and colleagues published the first medical account of what would eventually become known as AIDS. It was a short summary in the Centers for Disease Control and Prevention’s printed weekly newsletter of five cases of pneumonia in gay men, all of whom eventually died. The global story that has unfolded since is an unspeakable tragedy. HIV/AIDS has claimed more than 32.7 million lives, dwarfing the toll of the current COVID-19 pandemic.
Yet it is also a story of hope and heroes, of activism and ingenuity that spurred one of the most extraordinary scientific achievements of the 20th century. The development of antiviral drug combinations turned what had been a death sentence into a manageable chronic disease for millions and launched efforts to make these expensive medications available at low cost to the developing world. Today more than 26 million people are accessing antiretroviral therapy. AIDS-related deaths have fallen 60% since their peak in 2004.
Still, this triumph is far from complete. Each year, more than 1.7 million people around the globe are infected. Stigma, racism, underfunding and health care inequalities have left HIV/AIDS increasingly rooted in disadvantaged and marginalized communities. Effective treatments in the U.S. can cost $39,000 a year. There is still no vaccine. There are treatments, but there is no cure.
Fred Hutchinson Cancer Research Center, with a scientific staff grounded in virology and immunology, has been a global leader in the scientific efforts to stop this pandemic. Over the years, the Hutch has told scores of stories about the people and the science involved in this work — a vast collaboration of researchers, activists, government policymakers and industry pursuing a common goal. To mark 40 years since the emergence of this disease, we offer here a selection of 40 stories of hope and heroes, written by Fred Hutch writers about the work that has been done and the unfinished business ahead.
Also, you can watch a video of the AIDS@40: Remembering & Renewal virtual event, hosted by Fred Hutch President & Director Dr. Tom Lynch.
Dr. Larry Corey, former president and director of Fred Hutch, is an acclaimed virologist and principal investigator of the Hutch-based HIV Vaccine Trials Network, or HVTN. After helping pave the way to HIV treatments in the darkest early days of AIDS, Corey wants a vaccine — and a cure. We talked to him about his decades in HIV/AIDS research.
Dr. Julie McElrath saw her first patient with AIDS in the early 1980s, around the time HIV was identified. Today, she is senior vice president and director of the Vaccine and Infectious Disease Division at Fred Hutch, holder of the Joel D. Meyers Endowed Chair and director of HVTN’s laboratory division. She plays a key role in the largest international program for testing HIV and COVID-19 vaccines.
Dr. Jim Kublin, the HVTN’s executive director, brings epic life lessons to the quest to develop an HIV vaccine. Kublin talked with us about his years of working on malaria and HIV, and dogsledding, and what he’s learned along the way
Renaissance man (May 2014)
Timothy Ray Brown — known as the “Berlin patient” — was the first person to be cured of HIV as a result of a blood stem cell transplant to treat his leukemia. He found purpose and community in being involved in HIV cure research, both as a participant and as an advocate. Brown died of his leukemia in 2020.
Timothy Ray Brown: The accidental AIDS icon (Feb. 2015)
Bill Hall was diagnosed with HIV in June 1986 and assumed he had been sentenced to death. Twenty years later, still very much alive, he received another frightening diagnosis, non-Hodgkin lymphoma. The experience is increasingly common among people living with HIV.
First HIV, then cancer (Oct. 2015)
Dr. Julie Overbaugh, who holds the Endowed Chair for Graduate Education at the Hutch, for much of her research career has focused on people particularly vulnerable to HIV and its effects: commercial sex workers and HIV-positive mothers and their infants in Kenya.
Basic research to prevent HIV (Feb. 2017)
Wakefield, as he is known to all his former colleagues at Fred Hutch, began his career as 8-year-old member of the Rev. Jesse Jackson’s Operation Breadbasket. He became a prominent AIDS activist and eventually retired last year from HVTN after 20 years of bridge-building between vaccine researchers and underserved communities in Seattle and around the globe.
The pride of Fred Hutch: (June 2018)
Dr. Glenda Gray, president and CEO of the South African Medical Research Council, is co-principal investigator of the HVTN and directs its programs in Africa. Her fearless drive to stop HIV was forged in the fight against apartheid. She helped organize strikes, treated people injured in anti-government protests and documented brutalities against those detained in jail.
Glenda Gray: The HIV warrior (Nov. 2014)
Sister Glo joined the Seattle branch of the San Francisco-based Sisters of Perpetual Indulgence nearly two decades ago. The Sisters may be the oldest organization in the country dedicated to grassroots HIV prevention efforts, without losing, in Sister Glo’s words, “our activist, anarchist heart.”
Dr. Gregory Wilson is co-principal investigator for the Vanderbilt HIV Vaccine Trials Program in Nashville, Tennessee, a unit of the Fred Hutch-based HVTN. The pediatrician shares his story of his early experiences in treating children with HIV at a time when today’s effective antivirals were not yet available.
Gail Broder said she got into HIV work because she got tired of burying her friends. Trained as a music therapist helping patients with Alzheimer’s disease, she began to see parallels among patients with AIDS-related dementias. She shifted her focus and training to HIV prevention work, and in 2003 she joined HVTN, where she is now senior community engagement project manager.
Tranisha Arzah learned at the age of 7 that her mother and brother had died of complications of AIDS. That’s also when she found out that she, like her brother Tradell, had been born with HIV. As a young woman, she found her voice as an advocate for woman with HIV and a Community Advisory Board member for defeatHIV, a collaboration of scientists, clinicians and community dedicated to finding an HIV cure.
A voice for HIV cure (Nov. 2017)
When COVID-19 began spreading in the Seattle area in February 2020, there was immediate concern that it could be particularly dangerous for people living with HIV, a virus that can damage the immune system. Research so far suggests it is not the case among those who control HIV with antiretroviral drugs.
When COVID-19 crosses paths with HIV (May 2020)
Hutch researcher Dr. Justin Taylor and colleagues are pioneering an entirely new field of microbiology: B-cell engineering. The idea is to genetically modify antibody-producing B cells to produce immune proteins customized to stop hard-to-treat viral infections.
A Hutch-led study has shown that patients with HIV and one of a variety of potentially deadly cancers could be safely treated with the immunotherapy drug pembrolizumab. The study findings strengthen the case for opening the door to cancer clinical trials for people with HIV, where exclusion in cancer treatment trials has been a longstanding problem.
At a scientific meeting for researchers in Seattle, top scientists including Dr. Carl Dieffenbach, who oversees global HIV/AIDS research at the National Institutes of Health, discussed an ambitious plan to bring new HIV infection in the U.S. to zero by 2030 through expanded outreach, testing and treatment, and use of pre-exposure prophylaxis, or PrEP drugs.
Hutch researchers in collaboration with doctors in Africa have identified from vaginal swab samples seven bacterial species whose presence in high concentrations may significantly increase the risk of HIV infection in women. These clues from the microbiome are particularly important in sub-Saharan Africa, where women account for 56% of new HIV infections.
Microbiome research refines HIV risk for women (Jan. 2018)
Fred Hutch virologist Dr. Julie Overbaugh and her collaborators in Kenya and the U.S. celebrated the 25th anniversary of a collaboration with a unique group of HIV research participants — high-risk women in Mombasa, Kenya — who helped change the landscape of HIV transmission research.
25 powerful years of HIV research (Feb. 2018)
We now know that the gut microbiome can profoundly affect our immune response. Hutch vaccine researcher Dr. Jim Kublin and his team are studying how certain bacteria in the gut might have dampened the effectiveness of vaccines.
Enlisting the microbiome in the quest for an AIDS vaccine (Nov. 2017)
The AIDS Vaccine Early-Stage Investigator Programme was established by the Hutch-based HVTN in South Africa to help train a new generation of homegrown HIV physician-scientists in that nation, which has far fewer physicians overall and a far greater number of people with HIV than the U.S.
Training tomorrow's HIV researchers (June 2017)
Using a laboratory technique known as deep mutational scanning, Fred Hutch evolutionary biologist Dr. Jesse Bloom and his team created a library of possible mutant HIV surface proteins to simulate how they might respond to different antibodies.
Hutch researcher Dr. Jennifer Adair’s Gene Therapy in a Box aims to bring down the cost of eventually using gene therapy to treat diseases like HIV by automating multiple steps in the process of modifying a person’s own immune cells with genes that confer resistance to HIV.
Women scientists and activists are playing critical roles in the effort to stop the HIV/AIDS pandemic. In 2015, Fred Hutch hosted a seminar featuring prominent women in the field at home and abroad.
Women in the front lines of the HIV/AIDS Pandemic (March 2015)
Dr. Michael Emerman, a Fred Hutch virologist who studies the evolution of viruses, traces the emergence of SIVcp, a retrovirus in chimpanzees thought to have jumped to humans, leading to HIV, the virus that causes AIDS.
HIV’s unusual family tree (Sept. 2015)
In a significant breakthrough in HIV prevention, the CDC in 2015 recommended that Americans at high risk of contracting HIV take a daily pill that was shown to prevent infection. Since that endorsement of the pill, Truvada, new and more lasting forms of pre-exposure prophylaxis, or PrEP, have been developed.
Results of the Antibody Mediated Prevention, or AMP trials, released in January, were a proof of principle that infusions of a broadly neutralizing antibody could prevent infection in people at risk for HIV — if those antibodies matched certain viral strains at defined levels of potency.
Antibody trial results offer ‘proof of concept’ (Jan. 2021)
Now that daily PrEP pills and long-term injections have been shown to protect people from infection with HIV, will volunteers still sign up for a vaccine trial where they might receive a placebo? Vaccine researchers say that the need for a vaccine is as great as ever, and they can still find willing participants.
HIV vaccine trials are complicated by the availability of PrEP (Nov. 2020)
Just as the COVID-19 pandemic began to spread, hopes for good news on HIV vaccines were dashed by the surprising failure of HVTN’s Uhambo trial, a large multinational study of a vaccine meant to improve upon the promising results of a 2009 vaccine trial in Thailand, which reduced infections by 32%.
Promising HIV vaccine fails to show efficacy (Feb. 2020)
A new large HIV vaccine trial, Mosaico — like its companion study, Imbokodo — is testing a new vaccine inspired by the concept of a mosaic. It is built using parts, like mosaic tiles, from many different HIV strains found around the world. The idea is to overcome HIV’s ability to rapidly escape, through mutation, the protection offered by a vaccine containing a single strain.
Hutch researchers are exploring a new way of training the immune system to build broadly neutralizing antibodies against HIV through a series of steps that generate precursors of these potent immune proteins — a kind of directed evolution of antibodies.
Blood samples from a study of mother-to-child transmission of HIV conducted in Kenya decades are yielding clues that babies develop neutralizing antibodies to HIV. Dr. Julie Overbaugh and her team are studying whether these antibodies in children might inform development of a vaccine.
Dr. Leo Stamatatos and colleagues at Fred Hutch are probing the body’s ability to generate broadly neutralizing antibodies, which can overcome shape-shifting HIV’s ability to elude the kind of antibodies that vaccine elicit to stop other viral diseases like polio and measles.
Closing in on the ‘holy grail’ of HIV vaccine (Dec. 2014)
Dr. Hans-Peter Kiem, who directs the Cell & Gene Therapy Program at Fred Hutch and holds the Stephanus Family Endowed Chair for Cell and Gene Therapy, is an advocate for using “gene-therapy in a syringe” to cure HIV. In a TEDxSeattle talk, he explains why the idea is not “pie in the sky.”
Dr. Hans-Peter Kiem speaks about HIV and making gene therapy more accessible(Jan. 2020)
Hopes for an HIV cure were boosted by the news that a second patient, a man in London later identified as Adam Castillejo, had been cured of HIV — like Timothy Ray Brown — through a stem cell transplant of cells containing HIV resistance genes.
Proliferation or replication? A Hutch study suggests HIV persists despite antiviral therapy through the proliferation, or an increase in the number of infected cells, rather than by replication of viruses hiding in caches throughout the body. It means HIV might be best cleared by therapies that reduce cell proliferation, a standard strategy for blocking cancers.
Dr. Carl June was an oncology fellow trained at Fred Hutch in bone marrow transplantation before he became a leading developer of CAR T-cell therapies for cancer at the University of Pennsylvania. He called his Seattle years “a transformative time” in his career, and while researching HIV at a Navy-funded lab he cemented his T-cell expertise. In a career spanning the worlds of HIV and cancer research, he sits on the board of defeatHIV and was keynote speaker at a Hutch’s HIV cure conference.
Advisers to defeatHIV Community Advisory Boards held 10 focus groups around the country to ask how people with HIV felt about participating in HIV cure research. Then they shared their findings with the participants.
Why volunteer for an HIV cure study? (June 2017)
Super survivors: Fewer than 5% of people living with HIV are long-term nonprogressors, who maintain low viral loads and stable levels of immune cells without medication. A smaller number of them are elite controllers, who have undetectable viral loads and normal immune cell counts. In this story we profile five of these super survivors, who are the focus of intense interest by researchers at Fred Hutch and throughout the country.
Super survivors: What those with HIV who don’t get sick can teach us (Dec. 2015)
Dr. Françoise Barré-Sinoussi shared a Nobel Prize in medicine for the 1983 discovery of HIV, the retrovirus that causes AIDS. At Fred Hutch in 2014, she addressed the Conference on Cell & Gene Therapy for HIV Cure, making the case that scientists must still work toward a cure.
To mark 40 years of HIV, Fred Hutch President and Director Dr. Tom Lynch hosted AIDS@40: Remembering & Renewal, a program to remember those who work tirelessly in response to the epidemic. The hour-long presentation celebrated the strength and resilience of people who have been living with HIV for decades and reaffirms our vision to end HIV for everyone everywhere. You can view the entire program, which took place on June 2, 2021, by clicking on the image above.
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