Doctor who first noticed AIDS reflects on 20 years

The Associated Press
Tuesday June 05, 2001

LOS ANGELES — Dr. Michael Gottlieb sent the researcher up to 5-East in the UCLA Medical Center. 

Scout the wing for interesting immunological cases, Gottlieb told him, and bring back something to discuss. 

The researcher did just that, returning with word of a young gay man had a low white blood cell count, strange fungal infections and a rare type of pneumonia normally found only in people with severely suppressed immune systems. 

It took just two more patients for Gottlieb to realize something was afoot. 

“It was clearly something new and something unique and the mystery was what was causing it.  

That was the burning question,” Gottlieb, now a 53-year-old immunologist in private practice, said in a recent interview. 

Some sleuthing found two more patients in the San Fernando Valley. Another at Cedars-Sinai Medical Center. A Centers for Disease Control officer located a fifth. 

A report on the five cases was submitted to the CDC’s Morbidity and Mortality Weekly Report.  

The bare-bones, page-and-half write-up appeared June 5, 1981, overshadowed by reports of dengue fever in American tourists returning from the Caribbean. 

Although it wouldn’t be isolated or named for another two years, AIDS had arrived after lurking undetected in infected humans for decades. 

Armed with the five Los Angeles cases, the CDC started looking in other cities with sizable populations of gay men. 

“Lo and behold, there were lots of cases,” said Gottlieb of the disease he would later be criticized for provisionally dubbing “GRID,” or Gay Related Immunodeficiency Disease. 

In the first years, the number stayed small. By the end of 1981, there were fewer than 200 AIDS cases in the United States. 

“It appeared to be an outbreak, not an epidemic,” Gottlieb said.  

“In 1981, it’s a colossal understatement to say no one would have predicted 20 years later 34 million people around the world would be infected.” 

The death toll has been staggering. In the 20 years since Gottlieb and his colleagues tracked those first five cases, nearly 450,000 have died of AIDS in the United States alone.  

Worldwide, the number is 22 million. 

Gottlieb said his early patients were understanding of science’s ignorance of what was killing them, on average just nine months after suffering from the first opportunistic infections that were the disease’s hallmark. 

“They must have felt like astronauts returning to Earth with an extraterrestrial virus and no one knew what to do,” he said. 

Today, after two decades of working with AIDS patients, Gottlieb said he is afraid the mainstream population is growing tired of hearing about the disease, for which there is still no cure. 

New and powerful drugs, however, are allowing people with AIDS to live longer than ever before.  

While not a cure, it has allowed Gottlieb to continue working in the field. 

“With AIDS, there was the cumulative burden of having so many of my patients die,” said Gottlieb, who says he has lost hundreds of patients.  

“Even as a physician, you grieve.”