Who's in the Video
David Ho is the Scientific Director & CEO of the Aaron Diamond AIDS Research Center. Ho’s laboratory has focused on the pathogenesis of HIV infection. Most recently, his group has[…]
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Time’s Man of the Year in 1996 discusses how his background in physics helped him develop the Highly Active Anti-Retroviral Treatment (HAART) that revolutionized AIDS treatment in the mid-1990s.

Question: How did your education prepare you for your eventual development of an HIV drug "cocktail?"

This is where my quantitative background in physics applied; we realized that we could actually write that out mathematically in a straightforward differential equation that an AP high school student would be able to do. And from there, fitting the data and doing the calculation we were able to come up with the idea. We were using the drugs to block virus infection and production and therefore the precipitous decline reflected the fact that the virus was constantly being cleared at a very rapid rate. So using that quantitative background we were able to calculate what the turnover of virus was all the time in a given infected person and that number turned out to be enormously large, so the virus was just replicating away at a rapid clip.

And from there we also knew that HIV changes every time it replicates, so high replication rate meant high error rate and therefore HIV was able to mutate very quickly. We could then do the additional calculation to show that if you treat this virus with one or two drugs at a time, the virus is predictably going to mutate and escape from the action of the drugs. But at the same time we could also calculate what it would take to corner the virus so it’s not able to escape. Those calculations suggested to us that three or more drugs would do the trick. So we knew that by 1995 and launched a series of experiments in patients using what is now called a cocktail therapy of three drugs or more. And immediately, within weeks, we saw the good result. But we wanted to wait to see if the results could be sustained and it was only by middle of 1996 we realized that we were able to keep the virus below detection level for a good year and that opened up the door for what is called combination therapy today.

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