Michael S. Gottlieb

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Michael Stuart Gottlieb (born 1947) is an American physician and immunologist known for his 1981 identification of acquired immune deficiency syndrome (AIDS) as a new disease, and for his HIV/AIDS research, HIV/AIDS activism, and philanthropic efforts associated with HIV/AIDS treatment.

Contents

Biography

A native of Highland Park, New Jersey, he graduated from the Rutgers Preparatory School (1965) and Rutgers University (1969). [1] He graduated from the University of Rochester School of Medicine (1973) and trained in internal medicine at Strong Memorial Hospital in Rochester, New York. Following a fellowship in immunology at Stanford University in Palo Alto, California, in 1980 Gottlieb accepted an assistant professor of medicine position at the UCLA School of Medicine in Los Angeles. [2]

Identification of AIDS

Beginning in January 1981, Gottlieb, then thirty-three, and several colleagues identified an apparent novel immunologic condition in homosexual men; the condition had common features of cytomegalovirus infection, pneumocystis pneumonia, mucosal candidiasis, and Kaposi's sarcoma, all conditions found rarely outside of immunosuppressed patients. [3] Gottlieb reported an initial five patient series in the June 5, 1981, Morbidity and Mortality Weekly Report [4] and published a more detailed report in December, 1981, in the New England Journal of Medicine. [5] The New England Journal paper included the first description of the CD-4 T cell deficiency which is the immunologic hallmark of HIV infection. The work of Gottlieb and others suggested that these patients had an acquired immunodeficiency, characterized by depressed T-lymphocyte numbers and function, allowing for potentially fatal opportunistic infections. Initially, the researchers termed the disease Gay-Related Immune Deficiency (GRID); [6] in 1982 this syndrome became known as AIDS, a consequence of infection by Human immunodeficiency virus (HIV).

Physician Joel Weisman was one of Gottlieb's early collaborators in the identification of AIDS. [2] Weisman's practice treated a large number of gay men, some of whom were among the first identified AIDS patients. [2] [3] [7]

Gottlieb was Rock Hudson's doctor following the actor's AIDS diagnosis until his death in 1985. [2] [3] He was also physician to the late Elizabeth Glaser, co-founder of the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). In 1987 he resigned from the full-time UCLA faculty, and established a private practice of internal medicine and clinical immunology. In the period 1981–1987 he published 50+ papers [8] on various aspects of HIV infection and treatment. He was an investigator on the early clinical trials of AZT that led to approval by the U.S. Food and Drug Administration (FDA) in 1987. Gottlieb was the principal investigator on a $10.3 million National Institutes of Health contract for an AIDS Clinical Trials Group (ACTG) awarded to UCLA to test potential therapies for HIV. His work in the early years of the epidemic is chronicled in Randy Shilts' book And the Band Played On .

AIDS research philanthropy

Gottlieb, Elizabeth Taylor, and Mathilde Krim were founding chairs of the American Foundation for AIDS Research. [3] The organization was established with a $250,000 gift from the estate of Rock Hudson. He served on the boards of AIDS Project Los Angeles (APLA), the Pasadena AIDS Services Center and the Global AIDS Interfaith Alliance (www.thegaia.org), an NGO working in Malawi, Africa. He is currently Medical Advisor to GAIA and to the Elizabeth Taylor AIDS Foundation.

Clinical practice

Gottlieb is certified with the American Board of Medical Specialties in Internal Medicine and Allergy & Immunology. [8] He is affiliated with two hospitals, Cedars-Sinai Medical Center and the Olympia Medical Center where he is Committee Chairman of Bioethics. He continues on the faculty of the David Geffen School of Medicine at UCLA with the rank of Associate Clinical Professor of Medicine.

In 1989 Gottlieb and two other physicians were sent letters of reprimand by the Medical Board of California for "allegedly over-prescribing controlled substances" to actress Elizabeth Taylor. [2] He attempted to dispute the Letter of Reprimand; his attorney's request was rejected by the board.

In 1997, Gottlieb was inducted into the Rutgers University Hall of Distinguished Alumni, and in 2007, he was awarded the Charles Force Hutchison and Marjorie Smith Hutchison Medal by the University of Rochester.

In 2019, he joined the APLA Health medical team; he retired in late 2023.

Related Research Articles

Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that affect the patient's immune system. Examples of these extrinsic factors include HIV infection and environmental factors, such as nutrition. Immunocompromisation may also be due to genetic diseases/flaws such as SCID.

<span class="mw-page-title-main">Adenosine deaminase deficiency</span> Medical condition

Adenosine deaminase deficiency is a metabolic disorder that causes immunodeficiency. It is caused by mutations in the ADA gene. It accounts for about 10–20% of all cases of autosomal recessive forms of severe combined immunodeficiency (SCID) after excluding disorders related to inbreeding.

<span class="mw-page-title-main">Grethe Rask</span> Danish surgeon, one of the earliest non-Africans to die of AIDS

Margrethe P. Rask, better known as Grethe Rask, was a Danish physician and surgeon in Zaïre. After setting up her own hospital in the village of Abumombazi in 1972, she transferred to Danish Red Cross Hospital in Kinshasa in 1975. She returned to Denmark in 1977 after developing symptoms of an unknown infectious disease, which was later discovered to be AIDS. Three and a half years later in June 1981 the Centers for Disease Control recognized AIDS. Rask was one of the first non-Africans and first woman known to have died of AIDS-related causes.

This is a timeline of HIV/AIDS, including cases before 1980.

<span class="mw-page-title-main">Opportunistic infection</span> Infection caused by pathogens that take advantage of an opportunity not normally available

An opportunistic infection is an infection caused by pathogens that take advantage of an opportunity not normally available. These opportunities can stem from a variety of sources, such as a weakened immune system, an altered microbiome, or breached integumentary barriers. Many of these pathogens do not necessarily cause disease in a healthy host that has a non-compromised immune system, and can, in some cases, act as commensals until the balance of the immune system is disrupted. Opportunistic infections can also be attributed to pathogens which cause mild illness in healthy individuals but lead to more serious illness when given the opportunity to take advantage of an immunocompromised host.

AIDS-defining clinical conditions is the list of diseases published by the Centers for Disease Control and Prevention (CDC) that are associated with AIDS and used worldwide as a guideline for AIDS diagnosis. CDC exclusively uses the term AIDS-defining clinical conditions, but the other terms remain in common use.

<span class="mw-page-title-main">History of HIV/AIDS</span> Epidemiological history

AIDS is caused by a human immunodeficiency virus (HIV), which originated in non-human primates in Central and West Africa. While various sub-groups of the virus acquired human infectivity at different times, the present pandemic had its origins in the emergence of one specific strain – HIV-1 subgroup M – in Léopoldville in the Belgian Congo in the 1920s.

WHO Disease Staging System for HIV Infection and Disease in Adults and Adolescents was first produced in 1990 by the World Health Organization and updated in September 2005. It is an approach for use in resource limited settings and is widely used in Africa and Asia and has been a useful research tool in studies of progression to symptomatic HIV disease.

The CDC Classification System for HIV Infection is the medical classification system used by the United States Centers for Disease Control and Prevention (CDC) to classify HIV disease and infection. The system is used to allow the government to handle epidemic statistics and define who receives US government assistance.

Hypogammaglobulinemia is an immune system disorder in which not enough gamma globulins are produced in the blood. This results in a lower antibody count, which impairs the immune system, increasing risk of infection. Hypogammaglobulinemia may result from a variety of primary genetic immune system defects, such as common variable immunodeficiency, or it may be caused by secondary effects such as medication, blood cancer, or poor nutrition, or loss of gamma globulins in urine, as in nonselective glomerular proteinuria. Patients with hypogammaglobulinemia have reduced immune function; important considerations include avoiding use of live vaccines, and take precautionary measures when traveling to regions with endemic disease or poor sanitation such as receiving immunizations, taking antibiotics abroad, drinking only safe or boiled water, arranging appropriate medical cover in advance of travel, and ensuring continuation of any immunoglobulin infusions needed.

HIV/AIDS was recognised as a novel illness in the early 1980s. An AIDS case is classified as "early" if the death occurred before 5 June 1981, when the AIDS epidemic was formally recognized by medical professionals in the United States.

<i>Pneumocystis</i> pneumonia Medical condition

Pneumocystis pneumonia (PCP), also known as Pneumocystis jirovecii pneumonia (PJP), is a form of pneumonia that is caused by the yeast-like fungus Pneumocystis jirovecii.

Merle Alden Sande was a leading American infectious-diseases expert whose early recognition of the looming public health crisis posed by AIDS led to the development of basic protocols for how to handle infected patients. He graduated from Washington State University and received his MD degree from the University of Washington, School of Medicine in Seattle.

<span class="mw-page-title-main">Jane Aronson</span> American physician

Jane Aronson, D.O. is an osteopathic physician, with expertise in pediatric infectious diseases and adoption medicine.

Joel D. Weisman D.O. was one of the first to identify a pattern of illnesses that was ultimately diagnosed as AIDS during his work as a general practitioner in the United States. He later became an advocate for the development of treatments and prevention of the disease.

<span class="mw-page-title-main">Signs and symptoms of HIV/AIDS</span>

The stages of HIV infection are acute infection, latency, and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, swollen lymph nodes, inflammation of the throat, rash, muscle pain, malaise, and mouth and esophageal sores. The latency stage involves few or no symptoms and can last anywhere from two weeks to twenty years or more, depending on the individual. AIDS, the final stage of HIV infection, is defined by low CD4+ T cell counts, various opportunistic infections, cancers, and other conditions.

Julio S. G. Montaner, is an Argentine-Canadian physician, professor and researcher. He is the director of the British Columbia Centre for Excellence in HIV/AIDS, the chair in AIDS Research and head of the Division of AIDS in the Faculty of Medicine at the University of British Columbia and the past-president of the International AIDS Society. He is also the director of the John Ruedy Immunodeficiency Clinic, and the Physician Program Director for HIV/AIDS PHC. He is known for his work on HAART, a role in the discovery of triple therapy as an effective treatment for HIV in the late 1990s, and a role in advocating the "Treatment as Prevention" Strategy in the mid-2000s, led by Myron Cohen of the HPTN 052 trial.

<span class="mw-page-title-main">AIDS amendments of 1988</span> US law

AIDS amendments of 1988, better known as the Health Omnibus Programs Extension (HOPE) Act of 1988, is a United States statute amending the Public Health Service Act. The Acquired Immune Deficiency Syndrome amendments were compiled as Title II - Programs with Respect to Acquired Immune Deficiency Syndrome within the HOPE Act of 1988. The Title II Act appropriated federal funding for Acquired Immune Deficiency Syndrome (AIDS) education, prevention, research, and testing. The U.S. legislative title provisioned the establishment of the presidentially appointed National Commission on AIDS. The S. 2889 legislation was passed by the 100th U.S. Congressional session and signed by President Ronald Reagan on November 4, 1988.

<span class="mw-page-title-main">Sandy Ford</span> American drug technician, identifier of first known AIDS cluster

Sandy Ford was a drug technician for the Centers for Disease Control in Atlanta, Georgia. In April 1981, she identified unusual clusters of young homosexual patients in New York and California with pneumocystis pneumonia and Kaposi's sarcoma and alerted her supervisor about it. Those patients had HIV/AIDS; pneumocystis pneumonia and Kaposi's sarcoma were later found to be AIDS-defining diseases.

James M. Oleske is an American pediatrician and HIV/AIDs researcher who is the emeritus François-Xavier Bagnoud (FXB) Professor of Pediatrics at Rutgers New Jersey Medical School in Newark, New Jersey. He is best known for his pioneering work in identifying HIV/AIDS as a pediatric disease, and treating and researching it beginning in the 1980s. He published one of the first articles identifying HIV/AIDS in children in JAMA in 1983 and was a co-author of one of the articles by Robert Gallo and others identifying the virus in Science in 1984.

References

  1. ↑ Forman, Rob (November 30, 2015). "Michael Gottlieb: the Rutgers alumnus who first identified the deadly disease we now call AIDS". Rutgers Today. Michael S. Gottlieb's older brother was Paul David Gottlieb. "Paul David Gottlieb". Austin American-Statesman. November 2, 2003.
  2. 1 2 3 4 5 "The Emergence of a Deadly Disease", David Brown, Washington Post, June 5, 2001
  3. 1 2 3 4 Elizabeth Fee & Theodore M. Brown (June 2006). "Michael S. Gottlieb and the Identification of AIDS". Am J Public Health. 96 (6): 982–3. doi:10.2105/AJPH.2006.088435. PMC   1470620 .
  4. ↑ Gottlieb MS (June 2006). "Pneumocystis pneumonia--Los Angeles. 1981". Am J Public Health. 96 (6): 980–1. doi:10.2105/AJPH.96.6.980. PMC   1470612 . PMID   16714472.

    Reprinted from Morbidity and Mortality Weekly Report of June 5, 1981

  5. ↑ Gottlieb MS, Schroff R, Schanker HM, Weisman JD, Fan PT, Wolf RA, Saxon A (December 1981). "Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency". N. Engl. J. Med. 305 (24): 1425–31. doi:10.1056/NEJM198112103052401. PMID   6272109.
  6. ↑ "HIV/AIDS – the discovery of an unknown, deadly virus", Infectious Disease News , June 1, 2006
  7. ↑ "Dr. Joel D. Weisman dies at 66; among the first doctors to detect AIDS", Elaine Woo, Los Angeles Times, July 23, 2009
  8. 1 2 , vitals.com, Comprehensive medical information on 720,000 doctors in the USA

Further reading

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