Daniel Berger (born November 25, 1957) is a leading HIV specialist in the United States. A clinical associate professor at the Chicago campus of the University of Illinois College of Medicine, Berger is also founder and medical director of Northstar Medical Center, Chicago's largest private HIV/AIDS research and treatment center.
Berger has received numerous awards for his work as a researcher and teacher, including the Charles E. Clifton Leadership Award "For excellence and leadership to the Chicago HIV community" (2006), the Distinguished Researcher in HIV Medicine Award from Serono Laboratories (2000) and the American College of Physicians’ Preceptor Award for outstanding teaching in internal medicine (1996).
Dr. Daniel Berger at Iceberg Projects, Chicago.
In 2021, Berger was recipient of the Visual AIDS Vanguard Award for his "exceptional work as an HIV specialist who has made essential contributions to HIV and AIDS medical treatments, as well as his passion for art and the legacy of art AIDS activism as a collector, curator, archivist, and philanthropist."
Biography
Born in Brooklyn, New York, Daniel Berger is the son of Hungarian immigrants Kathy and Kalman Berger and brother to Kenneth Ira Berger. Kathy Berger (1926-2016) was a survivor of Nazi Concentration camp Auschwitz, liberated from Bergen-Belsen at the end of WW II. Her biography and testimony has been recorded and documented in the Shoah Foundation archives (http://vhaonline.usc.edu/viewingPage.aspx?testimonyID=10290&returnIndex=0USC). Kalman Berger (1921 - 1984) was a survivor of Nazi slave labor in Hungary, Poland, Germany, and Russia. Berger's brother Kenneth Ira Berger is a Professor (Departments of Medicine and Neuroscience / Physiology) and Medical Director at the Tisch Pulmonary Function Lab at NYU. Has conducted extensive research and has more than 50 publications in the areas of pulmonary physiology, cardiovascular and pulmonary outcomes of World Trade Center exposure, mucopolysaccharidosis, Pompe's Disease and pulmonary manifestations of obesity (http://www.med.nyu.edu/biosketch/bergek01).
Berger received his B.S. from Touro College in New York City and his M.D. from Rosalind Franklin University of Medicine and Science (The Chicago Medical School North Chicago). He interned at Lutheran General Hospital of Park Ridge, Illinois and completed his residency at Saint Joseph Hospital of Chicago, Illinois.
HIV research
At Northstar Medical Center, where he serves as principal investigator, Berger has conducted nearly 200 HIV-related clinical trials. Well known in the antiretroviral drug research and development community, Berger has published dozens of articles in peer-reviewed medical journals and authored abstracts in many international conferences on HIV-related treatment.
During the first years of HIV treatment development, Berger presented his work on several watershed studies on the development of the drug cocktail. Highlights include a presentation at the 1992 International AIDS Conference describing the first use of combination therapy with zidovudine and didanosine for patients who were consistently p24 anti-genemic despite zidovudine monotherapy. Also, Berger conducted the first investigations of interleukin II in advanced HIV disease patients, presented at the 1998 International Conference on AIDS.
During the years 2005–2010, antiretroviral therapy for HIV disease experienced a revolution in therapeutics. Berger was heavily involved as principal investigator of these agents and co-authored several resultant iconic publications of trials including the Power 2, Titan, Duet and Startmrk studies and the first studies of elvitegravir. Berger often lectures to physicians around the US on topics relating to incorporating of newer antiretroviral therapies into treatment. Additionally, Berger frequently publishes editorial articles in the lay press.
From 2012 to the present, Berger has been conducting studies with newer antiretroviral agents and participating in clinical trials that have led to a fine-tuning of treatment of HIV infection and contributed to the development of Gilead Sciences' Stribild, Complera, TAF (Tenofovir Alfonamide), Genvoya, Odefsey and GS 9883, as well as Merck's non-nucleoside reverse transcriptase inhibitor MK-1439 (Doravirine). Current studies include a study of African American HIV patients (GS-US-380-4580) with the protocol title, "A Phase 3b, Multicenter, Open-Label Study to Evaluate Switching From a Regimen of Two Nucleos(t)ide Reverse Transcriptase Inhibitors (NRTI) plus a Third Agent to a Fixed Dose Combination (FDC) of Bictegravir/Emtricitabine/Tenofovir Alafenamide (B/F/TAF), in Virologically- Suppressed, HIV-1 Infected African American Participants."
Berger is currently involved in studies of newer antiretroviral agents with novel mechanisms of action: Lencapravir (which belongs to a new class of drugs called capsid inhibitors which can be administered by injection every 6 months) and Islatravir, from Merck (which belongs to a new class of ARV drugs called nucleoside reverse transcriptase translocation inhibitor [NRTTI]).
During the Covid-19 pandemic, Berger was a guest speaker at Larry Bernstein's What Happens Next? conference, speaking on "Treatments: Lessons learned from HIV."
In addition to his medical and research practices, Berger is an avid collector of contemporary art, with a specialization in works by African-American, Chicago-based and queer artists. In 2010, he opened Iceberg Projects, a not-for-profit art gallery, in a refurbished carriage house behind his home in Chicago's Rogers Park neighborhood. Iceberg Projects is operated by Berger and a board of arts professionals including Huey Copeland, Doug Ishcar, John Neff, Carrie Schneider, and Rebecca Walz. A Chicago Reader profile of Berger discussing his collection and work with Iceberg Projects is available at http://www.chicagoreader.com/Bleader/archives/2012/10/10/daniel-berger-quietly-redefining-what-it-means-to-support-the-arts.
Since 2012, Berger has been a member of the Board of Governors for the School of the Art Institute of Chicago. In 2016, he joined the Collections Committee of the Museum of Contemporary Art, Chicago. He is also Co-President of the board of trustees for the Leslie-Lohman Museum, New York, where he has been a trustee and Collections Committee member since 2016.
In 2014, Dr. Berger founded the Daniel Berger Barbara DeGenevieve Scholarship in Photography, a yearly scholarship to an individual enrolled in the School of the Art Institute of Chicago's MFA program honoring the late Barbara DeGenevieve. A year later, Berger was listed by Newcity’s The Art 50 as one of the top 50 most influential individuals in Chicago's Art Community.
In 2015, Berger acquired the archives of Art+Positive, an affinity group of ACT-UP NY. Later that year, Berger and John Neff (an artist, curator, and art educator who is a founding board member of Iceberg Projects) curated the first exhibition of the archives of Art+Positive, Militant Eroticism, at Iceberg Projects
Berger's arts-related publications include the books Militant Eroticism: The Art+Positive Archives of 2017, edited by Daniel S. Berger and John Neff and published by Sternberg Press (http://www.sternberg-press.com/?pageId=1802), and David Wojnarowicz: Flesh of My Flesh of 2018, from Iceberg Projects Press and distributed by SPD Books, Berkeley, CA (https://www.spdbooks.org/Products/9780692182963/david-wojnarowicz-flesh-of-my-flesh.aspx). For the 2016 exhibition Broken Flag, Iceberg Projects produced an accompanying chapbook of the same title by Daniel S Berger and curator Omar Kholeif.
Berger served as Co-President of Leslie Lohman Museum of Art from January 1, 2019 to January 1, 2021 and is now Chair of Collections and Acquisitions for the museum (where he helped craft the museum's first acquisitions policy). As co-president of LLMA, he was responsible in moving the Museum towards greater inclusivity, spearheading the museum's name change (striking LLM of "Gay and Lesbian Art" and incorporating "Queer" in its new vision statement). Berger was also co-president of the museum during the height of the COVID 19 pandemic and helped maintain financial and programmatic and functioning stability of the Museum during the crisis. He served as chair of a selection committee in search of an interim director and formed a selection committee to hire the permanent position of Museum Director.
Since January 2020, Berger has been a member of the Board of Advisors to the Block Museum of Art at Northwestern University.
Selected references
HIV: The First Year Book, An Essential Guide for the Newly Diagnosed, by Bret Grodeck, foreword by Daniel S. Berger MD, with substantial contributions throughout the book by Berger
Madruga, José Valdez; Berger, Daniel; McMurchie, Marilyn; Suter, Fredy; Banhegyi, Denes; Ruxrungtham, Kiat; Norris, Dorece; Lefebvre, Eric; De Béthune, Marie-Pierre; Tomaka, Frank; De Pauw, Martine; Vangeneugden, Tony; Spinosa-Guzman, Sabrina (2007). "Efficacy and safety of darunavir-ritonavir compared with that of lopinavir-ritonavir at 48 weeks in treatment-experienced, HIV-infected patients in TITAN: A randomised controlled phase III trial". The Lancet. 370 (9581): 49–58. doi:10.1016/S0140-6736(07)61049-6. PMID17617272. S2CID26084893.
Debbie Hagins, MD1, Princy Kumar, MD2, Michael Saag, MD3, Anson K. Wurapa, MD4, Indira Brar, MD5, Daniel Berger, MD6, Olayemi Osiyemi, MD7, Corrilynn O. Hileman, MD8, Moti Ramgopal, MD9, Cheryl McDonald, MD10, Christiana Blair, PhD11, Kristen Andreatta, PhD11, Sean E. Collins, MD, MS11, Diana M. Brainard, MD11, Hal Martin, MD, MPH11 on behalf of the BRAAVE2020 Investigators. "Switching to Bictegravir/Emtricitabine/Tenofovir Alafenamide in Black Americans with HIV-1: a Randomized Phase 3b, Multicenter, Open-label Study." JAIDS.
Madruga, José Valdez; Berger, Daniel; McMurchie, Marilyn; Suter, Fredy; Banhegyi, Denes; Ruxrungtham, Kiat; Norris, Dorece; Lefebvre, Eric; De Béthune, Marie-Pierre; Tomaka, Frank; De Pauw, Martine; Vangeneugden, Tony; Spinosa-Guzman, Sabrina (2007). "Efficacy and safety of darunavir-ritonavir compared with that of lopinavir-ritonavir at 48 weeks in treatment-experienced, HIV-infected patients in TITAN: A randomised controlled phase III trial". The Lancet. 370 (9581): 49–58. doi:10.1016/S0140-6736(07)61049-6. PMID17617272. S2CID26084893.
Zidovudine (ZDV), also known as azidothymidine (AZT), was the first antiretroviral medication used to prevent and treat HIV/AIDS. It is generally recommended for use in combination with other antiretrovirals. It may be used to prevent mother-to-child spread during birth or after a needlestick injury or other potential exposure. It is sold both by itself and together as lamivudine/zidovudine and abacavir/lamivudine/zidovudine. It can be used by mouth or by slow injection into a vein.
The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV, maintains function of the immune system, and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same-sex and opposite-sex partners so long as the HIV-positive partner maintains an undetectable viral load.
Protease inhibitors (PIs) are medications that act by interfering with enzymes that cleave proteins. Some of the most well known are antiviral drugs widely used to treat HIV/AIDS, hepatitis C and COVID-19. These protease inhibitors prevent viral replication by selectively binding to viral proteases and blocking proteolytic cleavage of protein precursors that are necessary for the production of infectious viral particles.
Reverse-transcriptase inhibitors (RTIs) are a class of antiretroviral drugs used to treat HIV infection or AIDS, and in some cases hepatitis B. RTIs inhibit activity of reverse transcriptase, a viral DNA polymerase that is required for replication of HIV and other retroviruses.
Stavudine (d4T), sold under the brand name Zerit among others, is an antiretroviral medication used to prevent and treat HIV/AIDS. It is generally recommended for use with other antiretrovirals. It may be used for prevention after a needlestick injury or other potential exposure. However, it is not a first-line treatment. It is given by mouth.
Tenofovir disoproxil, sold under the trade name Viread among others, is a medication used to treat chronic hepatitis B and to prevent and treat HIV/AIDS. It is generally recommended for use with other antiretrovirals. It may be used for prevention of HIV/AIDS among those at high risk before exposure, and after a needlestick injury or other potential exposure. It is sold both by itself and together in combinations such as emtricitabine/tenofovir, efavirenz/emtricitabine/tenofovir, and elvitegravir/cobicistat/emtricitabine/tenofovir. It does not cure HIV/AIDS or hepatitis B. It is available by mouth as a tablet or powder.
Saquinavir, sold under the brand name Invirase among others, is an antiretroviral medication used together with other medications to treat or prevent HIV/AIDS. Typically it is used with ritonavir or lopinavir/ritonavir to increase its effect. It is taken by mouth.
Emtricitabine/tenofovir, sold under the brand name Truvada among others, is a fixed-dose combination antiretroviral medication used to treat and prevent HIV/AIDS. It contains the antiretroviral medications emtricitabine and tenofovir disoproxil. For treatment, it must be used in combination with other antiretroviral medications. For prevention before exposure, in those who are at high risk, it is recommended along with safer sex practices. It does not cure HIV/AIDS. Emtricitabine/tenofovir is taken by mouth.
Delavirdine (DLV) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) marketed by ViiV Healthcare. It is used as part of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) type 1. It is presented as the mesylate. The recommended dosage is 400 mg, three times a day.
Darunavir (DRV), sold under the brand name Prezista among others, is an antiretroviral medication used to treat and prevent HIV/AIDS. It is generally recommended for use with other antiretrovirals. It is often used with low doses of ritonavir or cobicistat to increase darunavir levels. It may be used for prevention after a needlestick injury or other potential exposure. It is taken by mouth once to twice a day.
Integrase inhibitors (INIs) are a class of antiretroviral drug designed to block the action of integrase, a viral enzyme that inserts the viral genome into the DNA of the host cell. Since integration is a vital step in retroviral replication, blocking it can halt further spread of the virus. Integrase inhibitors were initially developed for the treatment of HIV infection, but have been applied to other retroviruses. The class of integrase inhibitors called integrase strand transfer inhibitors (INSTIs) are in established medical use. Other classes, such as integrase binding inhibitors (INBIs), are still experimental.
Elvitegravir (EVG) is an integrase inhibitor used to treat HIV infection. It was developed by the pharmaceutical company Gilead Sciences, which licensed EVG from Japan Tobacco in March 2008. The drug gained approval by the U.S. Food and Drug Administration on August 27, 2012, for use in adult patients starting HIV treatment for the first time as part of the fixed dose combination known as Stribild. On September 24, 2014, the FDA approved Elvitegravir as a single pill formulation under the trade name Vitekta. On November 5, 2015, the FDA approved the drug for use in patients affected with HIV-1 as a part of a second fixed dose combination pill known as Genvoya.
Rilpivirine, sold under the brand names Edurant and Rekambys, is a medication, developed by Tibotec, used for the treatment of HIV/AIDS. It is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) with higher potency, longer half-life and reduced side-effect profile compared with older NNRTIs such as efavirenz.
Cobicistat, sold under the brand name Tybost, is a medication for use in the treatment of human immunodeficiency virus infection (HIV/AIDS). Its major mechanism of action is through the inhibition of human CYP3A proteins.
Discovery and development of nucleoside and nucleotide reverse-transcriptase inhibitors began in the 1980s when the AIDS epidemic hit Western societies. NRTIs inhibit the reverse transcriptase (RT), an enzyme that controls the replication of the genetic material of the human immunodeficiency virus (HIV). The first NRTI was zidovudine, approved by the U.S. Food and Drug Administration (FDA) in 1987, which was the first step towards treatment of HIV. Six NRTI agents and one NtRTI have followed. The NRTIs and the NtRTI are analogues of endogenous 2´-deoxy-nucleoside and nucleotide. Drug-resistant viruses are an inevitable consequence of prolonged exposure of HIV-1 to anti-HIV drugs.
Jeffrey P. Nadler is an American Infectious Diseases and HIV/AIDS expert. His most recent position has been as Acting Director and Assistant Director of the Therapeutics Research Program, Division of AIDS (DAIDS), National Institute of Allergy and Infectious Diseases (NIAID) where he oversaw NIH/NIAID-sponsored national and international HIV/AIDS research.
Viral load monitoring for HIV is the regular measurement of the viral load of individual HIV-positive people as part of their personal plan for treatment of HIV/AIDS. A count of the viral load is routine before the start of HIV treatment.
Bictegravir/emtricitabine/tenofovir alafenamide, sold under the brand name Biktarvy, is a fixed-dose combination antiretroviral medication for the treatment of HIV/AIDS. One tablet, taken orally once daily, contains 50mg bictegravir, 200mg emtricitabine, and 25mg tenofovir alafenamide. It was approved for use in the United States in February 2018, and for use in the European Union in June 2018.
Chloe Meave Orkin is a British physician and Professor of HIV/AIDS medicine at Queen Mary University of London. She works as a consultant at the Royal London Hospital, Barts Health NHS Trust. She is an internationally renowned expert in HIV therapeutics and led the first phase III clinical trial of injectable anti-retrovirals. She is immediate past Chair of the British HIV Association, where she championed the Undetectable=Untransmittable (U=U) campaign within the United Kingdom. She is president elect of the Medical Women's Federation. Orkin is gay and was on the Top 100 Lesbian influencer lists in both the UK and in the US in 2020. She considers herself a medical activist and much of her work focuses on inequalities in healthcare and in Medicine.
Charles Williams Flexner is an American physician, clinical pharmaceutical scientist, academic, author and researcher. He is a Professor of Medicine at the Johns Hopkins University School of Medicine.
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