In early 1981, Michael Gottlieb was a 33-year-old assistant professor at the University of California Los Angeles Medical Center specializing in immunology. The patients he needed were scarce, and he had to search the entire hospital for patient candidates for his case studies. At that time, an investigation began into the situation of a young homosexual man, also named Michael, who had been hospitalized because he had unexplained fevers and significant weight loss . A blood test revealed that his immune system was severely impaired , as if he had been treated with chemotherapy for cancer. But he had been healthy until recently. The diagnosis posed an enigma. In five days he was discharged, although he was admitted again after a week with fever and pneumonia. In less than a year he passed away.
Michael was one of the five protagonists of a short report signed by Gottlieb and other physicians, in which Joel Weisman had a special contribution. This doctor was intrigued by other cases of homosexual patients in Los Angeles who had mouth lesions typical of candidiasis, a fungal ailment that was sometimes associated with a deficiency of T lymphocytes. It was published on June 5, 1981 in the Morbidity and Mortality Weekly Report , the newsletter of the US Centers for Disease Control and Prevention. That text spoke for the first time of a new disease that seemed to occur among gays and that over time would be called acquired immunodeficiency syndrome or, for its acronym, AIDS . No one imagined then that forty years later it would be a global pandemic – an estimated 33 million people have died due to different illnesses related to this disease – or that in 2019 there would be 38 million individuals carrying the virus that transmits it. That report was not exhaustive in terms of the list of symptoms or complications – many have been discovered later – and did not provide data on their causes. In fact, the human immunodeficiency virus or HIV, which causes AIDS, would not be isolated until 1983.
Gottlieb was the main author of the first detailed description of the disease, which appeared in the New England Journal of Medicine , in December 1981. In it, he showed deficiencies in the number and function of helper T lymphocytes (CD4 +), he stated that It was about an immunodeficiency that could be contacted and suggested that sexual contact was a transmission factor . Gottlieb, who dedicated his career to fighting AIDS, was one of the first specialists to use the antiretroviral AZT (zidovudine) to treat it. Gottlieb, Weisman, and other researchers found that the disease led to opportunistic infections , such as pneumonia caused by the bacterium Pneumocystis carinii , the same bacterium Michael had contracted. In the summer and fall of that year, other reports of gay patients with Kaposi’s sarcoma, a rare skin cancer, began to appear in both California and New York. In a few months, the first cases appeared in Europe.
Over time, AIDS has manifested itself through various infections that do not affect those with healthy immune systems, and various types of cancer. The main cause of death among those who suffer from it is tuberculosis . Today we know that HIV is spread sexually, through the blood and from mother to child during pregnancy, childbirth or breastfeeding. Triple antiretroviral therapy has been used since the mid-1990s, turning what was a deadly disease into a chronic disease, at least in developed countries.
