Twenty-Five Years of Translational Medicine in Antiretroviral Therapy: Promises to Keep

The year 2010 marks the 25th anniversary of modern antiretroviral drug discovery and development. In the early 1980s, AIDS was almost always a lethal disease with an appalling clinical course characterized by severe opportunistic infections and unusual forms of cancer. Since that time, starting with zidovudine (AZT) and related 2',3'-dideoxynucleosides, the causative retrovirus, now called HIV-1, went from being an untreatable infectious agent to being the target of highly active antiretroviral therapy (HAART). This degree of progress refuted early prophesies of therapeutic futility and represents a striking example of translational medicine. Here I review foundational discoveries and events in HIV-1/AIDS research and explore lessons for future translational medicine efforts.