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Montagnier, Luc - AIDS AND HIV

research virus disease institute

[mõtanyay] (1932–) French virologist: discoverer of HIV, the generally accepted cause of AIDS.

Montagnier studied science at Poitiers and science and medicine at Paris, becoming MD in 1960. From 1960–4 he worked in virology as a research Fellow for the Medical Research Council in the UK, initially at Carshalton and then in Glasgow. Returning to France, he headed research groups at Orsay, at the Pasteur Institute and for the National Centre for Scientific Research (CNRS), specializing in virology and becoming professor at the Pasteur Institute in 1985.

Recognition of Montagnier as the discoverer of the virus causing AIDS (see panel on p. 260) followed a period of some confusion in work on the cause of this disease. An early claim for the discovery was made in 1984 by R Gallo (1937– ) of the US National Cancer Institute. However, later and rather prolonged investigations on priority made in the USA showed that the retrovirus causing AIDS had been described and photographs of it published by Montagnier in May 1983, but the discovery was inadequately appreciated in the USA at that time. It seems clear that virus samples loaned by the French group to Gallo’s laboratory in early 1984 contaminated isolates in that laboratory and that Gallo’s discovery was in fact the French virus. By the 1990s it was also widely agreed that this virus (now known as HIV, with several strains recognized) is the central cause of AIDS, although Montagnier has argued that other organisms must be present together with this virus if the death of immune-system cells, characteristic of AIDS, is to occur in the patient.

AIDS AND HIV


In 1981, the first reports of a new disease came from medical centres on the USA’s West Coast. Its key feature was collapse of the body’s immune system, leading to low resistance to some cancers and to infections, such as pneumonia, which are usually treatable, but which in these cases were often fatal. By 1982 it was named as Acquired Immune Deficiency Syndrome (AIDS).

The AIDS epidemic spread, with deaths from it in the USA increasing from 2000 in 1984 to over 10 times as many in 1986. Its victims were then almost entirely among the ‘five H’s’: homosexual men, heroin addicts, hookers, Haitians and haemophiliacs. At a fairly early stage it was judged to be viral in origin, with its spread associated with the transfer of body fluids such as blood or semen during sexual contact, or from mother to child before birth, or during blood transfusion or by sharing of contaminated hypodermic needles. The 100% fatality rate and rapidly increasing number of victims (especially in Africa) clearly warranted major investigation.

However, the expansion of AIDS research soon exposed some unusual aspects. These included intense and damaging rivalry between two leading research groups (those led by at the Pasteur Institute in Paris and by Robert Gallo (1937–) of the National Cancer Institute in Washington, DC); the moralistic overtones associated with studies on a mainly sexually-transmitted disease; and the large sums of money linked with research on AIDS, on patentable test methods for identifying its victims and on drugs for its treatment.

By the early 1990s it was widely agreed that AIDS follows infection by one of the strains of a retrovirus, human immunodeficiency virus (HIV), which attacks the T-lymphocytes (a type of white blood cell). Then, after a period of normally some years, AIDS develops. Treatment was attempted from 1986 with the costly drug AZT (now called zidovudine), but a large-scale trial begun in 1988 showed by 1993 that this alone gave no clear benefits, whether the drug treatment began early on patients shown to be HIV-positive or was delayed until the full symptoms of AIDS were present.

Despite intensive efforts by epidemiologists to predict the pattern of spread of the disease, their projected figures have recurrently needed revision; the number of cases in the early 1990s was much below earlier projections. Predictions that the disease would spread among heterosexuals have largely been unfulfilled in the USA and northern Europe, but in parts of Africa have been realized, with up to 50% of the general population infected in countries such as Kenya, while significant infection in some less-developed European countries such as Romania has occurred through poor medical hygiene. Some geographical areas and population groups have remained unaffected by the epidemic (eg parts of the Middle East), for reasons that are unclear. The scale and intensity of research on AIDS is remarkable; by 1992, over 36 000 research papers had been published on it, over $6000 million had been spent on the study of the disease and an estimated 500 000 victims of it had died. By 2000 the UN estimated 35 million people were infected with HIV, most in sub-Saharan Africa but with rising numbers in Eastern Europe and in the former USSR.

As a result of this massive programme, HIV is one of the most fully studied of all disease-causing microorganisms. It is known to be highly variable, with its genetic make-up changing frequently to give new strains; this adds to the difficulty of devising a protective vaccine. But many questions are unanswered, such as: where and when did the virus originate? Why are so few T-lymphocytes in the blood of most HIV-positive people infected? Why is there a delay of typically 7 years between infection by HIV and the onset of AIDS? And why do a very small number of HIV carriers fail to develop AIDS?

Problems also arise with test animals. Chimpanzees are used because they can be infected with HIV. However, they are costly and not easy to work with, and their immunology does not model human patients closely – they are not made ill by HIV and do not proceed to develop AIDS. Trials of protective vaccines in human subjects will offer obvious problems. Despite the difficulties, the potential problem of AIDS is so important that great efforts will continue to be made both to develop a vaccine against HIV, and to secure more effective drugs for treatment: AIDS is seen by many workers as the greatest threat to public health of our time. Anti-retroviral drugs, which are palliative but not curative, are widely used in developed countries. By the end of 2000, over 5 million new HIV infections were occurring annually; and cumulative HIV/Aids-related deaths, worldwide, totalled 21.8 million.

Montaigne, Michel de (1533–1592) - BIOGRAPHY, CRITICAL RECEPTION [next] [back] Monod, Jacques (Lucien)

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