The first part of this diptych traces the dramatic beginnings of the AIDS epidemic, a global health upheaval which began in 1981 with the publication of the first report on a still unknown disease. As researchers embark on a frantic race to identify the cause, tensions arise between scientists, marking the start of a long battle for the authorship of this discovery.
In the early 1980s, a previously unknown disease appeared, heralding an unprecedented upheaval in the history of global public health. It all began on June 5, 1981, with the publication in the Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control and Prevention (CDC) in an article titled Pneumocystis Pneumonia – Los Angeles (Pneumocystis pneumonia in Los Angeles). This report describes a rare lung infection – usually mild in healthy adults – that affected five gay men in the California city.
Between October 1980 and May 1981, these patients were admitted to three hospitals in the city, presenting with various opportunistic infections. One of them survived Hodgkin’s lymphoma, a cancer to which HIV-positive people are particularly vulnerable. Two of the patients have already died at the time of publication, and the other three will succumb shortly thereafter. The authors of the report raise the possibility of a cellular immune deficiency. However, the precise link between these infections and this immune failure remains uncertain.
Although rare opportunistic infections had previously been observed among some gay men in coastal American cities, this publication was the first official recognition of a disease that would later be identified as acquired immune deficiency syndrome (or AIDS). . It also (and above all) marks the beginning of institutional awareness of an epidemic which will redefine the health and social issues of the following decades.
Political inaction
In the months that followed, the disease spread rapidly, particularly affecting marginalized populations, including homosexuals, drug addicts and hemophiliacs. In December 1981, 337 cases of severe immune deficiency were recorded. The CDC estimates, however, that about 42,000 people were HIV positive without knowing it at the time. Political inaction and social stigma further aggravate the crisis. As the disease progresses and spreads to other societies, it becomes clear that a previously unknown infectious agent is responsible for this outbreak. Aware of the health emergency, researchers are embarking on a frantic race to identify the cause of the disease and develop strategies aimed at containing, or at least limiting, its spread. In this quest, two teams stand out in particular: that led by the Frenchman Luc Montagnier, at the Institut Pasteur in Paris, and that of the American Robert Gallo, at the National Cancer Institute (NCI) which is part of the NIH (National Institutes of Health), located in Bethesda, in the Washington metropolitan area.
First major step
“After my doctorate at King’s College London, I joined the Pasteur Institute as a postdoctoral researcher in Luc Montagnier’s unit,” says Ara Hovanessian, former Lebanese research director at the CNRS of France, in an exclusive interview granted to Ici Beirut. “Professor Montagnier was a remarkable researcher in virology and cell biology. With my training in biochemistry, I joined his team to provide the skills and techniques necessary to advance our research. I quickly became his right-hand man.” In 1982, the French biologist carried out research on samples of lymph nodes taken from patients presenting lymphadenopathy, a common symptom of AIDS, characterized by an abnormal increase in the volume of the nodes.
A few months later, Montagnier managed to isolate a virus from these samples, thus taking a first major step towards understanding the disease. In the May 20, 1983 issue of the magazine Sciencethe French team published an article in which it identified a retrovirus that it called LAV (lymphadenopathy-associated virus) as the cause of AIDS. “Contrary to what is often reported in the press, Montagnier was the only one to orchestrate all of this work within his unit, in particular the analysis of the glycoproteins of the viral envelope and the observation of the virus under a microscope. electronic. Without him, this discovery simply could not have resulted in viral RNA sequencing,” explains Professor Hovanessian, suggesting that certain names were put forward despite limited contribution, for reasons that are not strictly scientists.
Start of the conflict
In the United States, Robert Gallo learned of the isolation of a virus in Paris, following the publication of the results by the Pasteur Institute group. “Gallo contacted Montagnier and asked him for a sample of the virus in order to compare it to those they had isolated from patients infected with AIDS. In accordance with the principles of scientific ethics, Montagnier accepts his request, the article having already been published,” specifies the Lebanese-French researcher. Barely a year later, in May 1984, Gallo and his team published, in turn, an article in Scienceannouncing that it had isolated a similar virus associated with AIDS. They call it HTLV-III (human T-lymphotropic virus type III or human T-lymphotropic virus type 3).
“It is important to specify that in 1983, the Pasteur Institute had filed a patent application in Europe for the diagnosis of HIV (LAV, at the time, according to the nomenclature of the Pasteur Institute), which was quickly accepted, while in the United States, its approval was delayed,” notes Professor Hovanessian. Interestingly, in 1984, the American NCI group filed a patent application in the United States for the diagnosis of HIV (HTLV-III, at the time, according to the NCI nomenclature), which was immediately accepted. Quite ironically, at least suspiciously, the French patent application was only validated in the United States after this date.
The tension quickly rises…
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