Much progress, still many challenges

The arc of laboratory and clinical research on HIV/AIDS began at ground zero in the epidemic, with no knowledge of the etiological agent or rational strategy for its treatment. Progress over the ensuing decades has been nothing short of miraculous, with the biology and patient care advancing to a level of extraordinary sophistication. The irony is that much of the intellectual infrastructure that proved beneficial in combating HIV/AIDS grew out of the misconceptions of President Nixon's 1971 War on Cancer. At that time, the prevailing hypothesis was that most human malignancies were due to viruses, as they are in many lower animals. Although this hypothesis turned out to be false, the study of retroviruses and cancer yielded considerable fruit with the discovery of reverse transcriptase. Adding to that enabling work was an explosion in technology, including structural biology with three-dimensional representations of proteins that expedited the identification of the protease inhibitors and monoclonal antibody development that assisted in the characterization of the receptors for HIV.