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Robert Yarchoan (born 1950) is a medical researcher who played an important role in the development of the first effective drugs for AIDS. He is the Chief of the HIV and AIDS Malignancy Branch in the NCI and also coordinates HIV/AIDS malignancy research throughout the NCI as director of the Office of HIV and AIDS Malignancy (OHAM).
Dr. Yarchoan was raised in Oceanside, New York and graduated from Amherst College in 1971. He subsequently received his M.D. from the University of Pennsylvania and completed an internship and residency in internal medicine at the University of Minnesota and a fellowship in Immunology in the Metabolism Branch of the NCI. After completing his training he joined the laboratory of Dr. Samuel Broder. In 1991 he was appointed to be a Section Chief of the Medicine Branch and in 1996 he named chief of the newly formed HIV and AIDS Malignancy Branch. Dr. Yarchoan was also appointed to be the first director of the NCI Office of HIV and AIDS Malignancy (OHAM) in 2007, which supervises all HIV/AIDS and AIDS malignancy research within the NCI.
Along with his colleagues Drs. Samuel Broder and Hiroaki Mitsuya in the National Cancer Institute (NCI), he co-developed the first effective treatments for HIV/AIDS. With his colleagues, he conducted the first clinical trials of zidovudine (AZT), didanosine (ddI), zalcitabine (ddC), and lamivudine (3TC). These trials were the first to demonstrate that administration of anti-retroviral drugs could reverse the declines in CD4 cells and immunologic impairment caused by human immunodeficiency virus (HIV) infection. Dr. Yarchoan also conducted the first trials of combination anti-HIV therapy.
The development of these drugs was a breakthrough in AIDS therapy. Zidovudine and didanosine were components of early highly active antiretroviral drug therapy (HAART), and zidovudine, didanosine, and lamivudine remain in widespread use and are included in the World Health Organization's "Essential Drugs List", which is a list of minimum medical needs for a basic health care system. It is estimated that the development of these and other AIDS drugs have saved over 3 million life-years in the United States and over 15 million life-years throughout the world. His research efforts have also focused on AIDS malignancies, focusing on the pathogenesis and treatment of Kaposi's sarcoma and other virus-associated tumors. He led the first clinical studies showing that paclitaxel was an effective therapy for Kaposi's sarcoma and that thalidomide has activity in this disease. He also developed several novel therapies for Multicentric Castleman's disease caused by Kaposi's sarcoma-associated herpesvirus (KSHV), also called human herpesvirus-8 [HHV-8]. With his colleagues at NCI, he also identified a new disease called KSHV-Associated Cytokine Syndrome (KICS) in some people with HIV/AIDS.
Yarchoan is a co-editor of several journals. He has received many awards, including the Assistant Secretary for Health Award and the U.S. Public Health Service Outstanding Service Medal. He also was awarded the first National Institutes of Health (NIH) World AIDS Day Award in December, 2006 for his work in developing drugs for AIDS. In November, 2007, he was awarded the NCI HIV/AIDS Research Excellence Award along with his colleagues, Drs. Samuel Broder, Robert C. Gallo, and Hiroaki Mitsuya. In October 2009, he received the National Cancer Institute Director's Awards of Merit for leadership in promoting and supporting HIV/AIDS research and HIV-associated malignancies at the National Cancer Institute, and in 2014 received the American Society for Microbiology Award in Clinical and Diagnostic Immunology. He has been inducted as a member of the American Society for Clinical Investigation, a Fellow of the American Association for the Advancement of Science (AAAS), and in 2016 as a member of the Association of American Physicians. In 2013, Dr. Yarchoan received an honorary degree for his contributions to HIV/AIDS research from his alma mater, Amherst College.
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The Duesberg hypothesis is the claim that AIDS is not caused by HIV, but, instead, that AIDS is caused by noninfectious factors such as recreational and pharmaceutical drug use and that HIV is merely a harmless passenger virus. The hypothesis was popularized by University of California, Berkeley professor Peter Duesberg, from whom the hypothesis gets its name. The scientific consensus is that the Duesberg hypothesis is incorrect and that HIV is the cause of AIDS. The most prominent supporters of the hypothesis are Duesberg himself, biochemist and vitamin proponent David Rasnick and journalist Celia Farber. The scientific community generally contends that Duesberg's arguments in favor of the hypothesis are the result of cherry-picking predominantly outdated scientific data and selectively ignoring evidence that demonstrates HIV's role in causing AIDS.
Zidovudine (ZDV), also known as azidothymidine (AZT), is an 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.
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.
Didanosine, sold under the brand name Videx, is a medication used to treat HIV/AIDS. It is used in combination with other medications as part of highly active antiretroviral therapy (HAART). It is of the reverse-transcriptase inhibitor class.
Zalcitabine, also called dideoxycytidine, is a nucleoside analog reverse-transcriptase inhibitor (NRTI) sold under the trade name Hivid. Zalcitabine was the third antiretroviral to be approved by the Food and Drug Administration (FDA) for the treatment of HIV/AIDS. It is used as part of a combination regimen.
Kaposi's sarcoma-associated herpesvirus (KSHV) is the ninth known human herpesvirus; its formal name according to the International Committee on Taxonomy of Viruses (ICTV) is Human gammaherpesvirus 8, or HHV-8 in short. Like other herpesviruses, its informal names are used interchangeably with its formal ICTV name. This virus causes Kaposi's sarcoma, a cancer commonly occurring in AIDS patients, as well as primary effusion lymphoma, HHV-8-associated multicentric Castleman's disease and KSHV inflammatory cytokine syndrome. It is one of seven currently known human cancer viruses, or oncoviruses. Even after many years since the discovery of KSHV/HHV8, there is no known cure for KSHV associated tumorigenesis.
This is a timeline of HIV/AIDS, including cases before 1980.
Hiroaki Mitsuya is a Japanese virologist famous for his role in discovery of the anti-HIV drug zidovudine (AZT) as well as other anti-AIDS drugs including didanosine (ddI) and zalcitabine (ddC).
Primary effusion lymphoma (PEL) is classified as a diffuse large B cell lymphoma. It is a rare malignancy of plasmablastic cells that occurs in individuals that are infected with the Kaposi's sarcoma-associated herpesvirus. Plasmablasts are immature plasma cells, i.e. lymphocytes of the B-cell type that have differentiated into plasmablasts but because of their malignant nature do not differentiate into mature plasma cells but rather proliferate excessively and thereby cause life-threatening disease. In PEL, the proliferating plasmablastoid cells commonly accumulate within body cavities to produce effusions, primarily in the pleural, pericardial, or peritoneal cavities, without forming a contiguous tumor mass. In rare cases of these cavitary forms of PEL, the effusions develop in joints, the epidural space surrounding the brain and spinal cord, and underneath the capsule which forms around breast implants. Less frequently, individuals present with extracavitary primary effusion lymphomas, i.e., solid tumor masses not accompanied by effusions. The extracavitary tumors may develop in lymph nodes, bone, bone marrow, the gastrointestinal tract, skin, spleen, liver, lungs, central nervous system, testes, paranasal sinuses, muscle, and, rarely, inside the vasculature and sinuses of lymph nodes. As their disease progresses, however, individuals with the classical effusion-form of PEL may develop extracavitary tumors and individuals with extracavitary PEL may develop cavitary effusions.
Samuel Broder is an American oncologist and medical researcher. He was a co-developer of some of the first effective drugs for the treatment of AIDS and was Director of the National Cancer Institute (NCI) from 1989 to 1995.
Patrick S. Moore is an Irish and American virologist and epidemiologist who co-discovered together with his wife, Yuan Chang, two different human viruses causing the AIDS-related cancer Kaposi's sarcoma and the skin cancer Merkel cell carcinoma. The couple met while in medical school together and were married in 1989 while they pursued fellowships at different universities.
Yuan Chang is a Taiwanese-American virologist and pathologist who co-discovered together with her husband, Patrick S. Moore, the Kaposi's sarcoma-associated herpesvirus (KSHV) and Merkel cell polyomavirus, two of the seven known human oncoviruses.
Lamivudine/zidovudine, sold under the brand name Combivir among others, is a fixed-dose combination antiretroviral medication used to treat HIV/AIDS. It contains two antiretroviral medications, lamivudine and zidovudine. It is used together with other antiretrovirals. It is taken by mouth twice a day.
The AIDS Clinical Trials Group network (ACTG) is one of the largest HIV clinical trials organizations in the world, playing a major role in setting standards of care for HIV infection and opportunistic diseases related to HIV and AIDS in the United States and the developing world. The ACTG is composed of, and directed by, leading clinical scientists in HIV/AIDS therapeutic research. The ACTG is funded by the Department of Health and Human Services, National Institutes of Health through the National Institute of Allergy and Infectious Diseases.
The latency-associated nuclear antigen (LANA-1) or latent nuclear antigen is a Kaposi's sarcoma-associated herpesvirus (KSHV) latent protein initially found by Moore and colleagues as a speckled nuclear antigen present in primary effusion lymphoma cells that reacts with antibodies from patients with KS. It is the most immunodominant KSHV protein identified by Western-blotting as 222–234 kDa double bands migrate slower than the predicted molecular weight. LANA has been suspected of playing a crucial role in modulating viral and cellular gene expression. It is commonly used as an antigen in blood tests to detect antibodies in persons that have been exposed to KSHV.
Kaposi's sarcoma (KS) is a type of cancer that can form masses in the skin, in lymph nodes, in the mouth, or in other organs. The skin lesions are usually painless, purple and may be flat or raised. Lesions can occur singly, multiply in a limited area, or may be widespread. Depending on the sub-type of disease and level of immune suppression, KS may worsen either gradually or quickly. Except for Classical KS where there is generally no immune suppression, KS is caused by a combination of immune suppression and infection by Human herpesvirus 8.
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.
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.
Large B-cell lymphoma arising in HHV8-associated multicentric Castleman's disease is a type of large B-cell lymphoma, recognized in the WHO 2008 classification. It is sometimes called the plasmablastic form of multicentric Castleman disease. It has sometimes been confused with plasmablastic lymphoma in the literature, although that is a dissimilar specific entity. It has variable CD20 expression and unmutated immunoglobulin variable region genes.
