The Department of Infectious Diseases and Microbiology (IDM), one of Pitt Public Health’s original four departments, has for more than three decades been largely defined by outstanding research and public health initiatives against HIV-1, the AIDS virus. Investigations by our faculty members have led to several important discoveries and have enabled scientists around the world to advance their research not only in AIDS but in virology, immunology, cancer, and other infectious diseases.
Back at the founding of Pitt Public Health we were known as the Department of Epidemiology and Microbiology (the department would divide in 1973). In the late 1940s, William McD. Hammon, our first chair, was the first to establish the mosquito as the major epidemic vector of the Western equine encephalitis virus. In 1960, Hammon also discovered two of the four types of dengue virus, which is still one of the major causes of severe tropical illness. Later in the 1960s, along with R.W. Atchison, he discovered adeno-associated virus, now used to deliver genes in therapy of several human diseases.
Monto Ho was the next department chair, and throughout the 1970s, he and his colleagues made important discoveries related to the epidemiology of cytomegalovirus infection, showing that it was transmitted to transplant recipients by the transplanted organ. They pioneered the investigation of interferon, a cytokine induced in viral infections that has antiviral properties, and they patented interferon enhancement that was useful for clinical production before recombinant interferon was available.
Later, Ho obtained a National Institutes of Health (NIH) grant to study the serology of organ transplant recipients and donors, collaborating with Thomas E. Starzl to show that development of lymphoma in organ transplant recipients was caused by Epstein-Barr virus, a herpesvirus transmitted through the donated organ. During the early 1980s, IDM faculty discovered a new species of the Legionella bacterium—later termed Legionella micdadei —that caused pneumonia in normal and immunocompromised hosts.
The work within IDM that has had the most worldwide impact evolved from a 1982 pilot study in Pittsburgh’s gay male community led by Charles R. Rinaldo of a mysterious illness that was later termed AIDS. This formed the basis of the University being awarded, in 1983, one of the National Institutes of Health (NIH) first major contracts for AIDS research of more than $4 million for a four-year project, the equivalent of more than $9.5 million in 2015. The national project was established at Pitt Public Health and three other major universities, and called the Multicenter AIDS Cohort Study (MACS). It was designed to elucidate the natural history of the infection causing AIDS, to identify risk factors for occurrence and clinical expression of the infection, and to establish a repository of biologic specimens for future study. The Pittsburgh portion is called the Pitt Men’s Study. It continues to be funded through the NIH. Having published nearly 1500 publications, the MACS has made significant contributions to understanding the science of HIV, the AIDS epidemic, and the effects of therapy. Many of these MACS publications have guided Public Health policy.
The Pitt Men’s Study portion of the MACS has become a model of community-based participatory research and how it translates into improvement of public health. Indeed, in 1996, several MACS researchers in IDM led by John Mellors showed that a single measurement of the amount of HIV in a patient’s blood could predict the subsequent risk of AIDS or death up to 10 years before the patient showed signs of the disease.
Other significant accomplishments related to the study of HIV/AIDS by Rinaldo, Phalguni Gupta, Lawrence A. Kingsley, and Anthony Silvestre have had to do with how the virus is spread, how to measure its progression, and interventions that have helped HIV-positive people live longer. Their research continues to be the basis for numerous studies in virology, immunology, neuropsychology, therapeutics, and prevention.