The Medscape Awards in Infectious Diseases: Most Important Virus

1980-2012

John G. Bartlett, MD

Disclosures

October 05, 2012

The Most Important Discovery of a Virus (1980-2012)

The Most Important Virus

In my opinion, HIV is the most important virus discovered since 1980. The disease caused by HIV was initially reported in 1981, with a description of 5 patients who had Pneumocystis carinii pneumonia in Los Angeles.[1] More recent reports indicate that 60 million people in the world have HIV; 25 million have died.[2]

HIV is not only a story of enormous human suffering, stigma, and mortality; HIV has also led to some of medicine's proudest moments: effective treatment of a retrovirus with antiretroviral agents; a symbiosis between scientists and activists; and the delivery of expensive, lifesaving treatment to areas of the world that many believed to be an impossible challenge. The major scientific question with HIV is no longer "how to manage the infection?" but "how to prevent and cure?"

Some of the other viruses deserve acknowledgement. For example, HTLV-1 was the first oncogenic virus. HCV has infected 170-200 million people worldwide and 3-5 million in the United States, where it now kills more people than HIV. From HIV we learned that it was possible to treat a chronic viral infection, and that has led to a surge of new HCV drugs (more than 30 in phase 2 or 3 development); it is likely that most patients will be cured. Ebola virus infection is untreatable, with rapid death occurring in up to 70% of cases in 3-5 years, but the number of cases is small. Avian influenza has infected 680 patients to date, and with mortality greater than 50%, this virus could be a contender for most important discovery of a virus if it acquires the ability to be transmitted more efficiently to humans. SARS is an amazing story. From a "cover-up" in China, the SARS virus went to a patient in room 911 of the Metropole Hotel in Hong Kong, and from there it went to hotel occupants in Canada, Vietnam, Taiwan, and Thailand. The SARS virus is still alive in the wild, but no further cases have been reported in humans.

The following is a list of other viruses that were discovered since 1980 but are not considered candidates on the basis of case numbers, severity, or disease potential.

1983: Hantavirus (hemorrhagic fever)

1986: Human herpesvirus-6 (multiple diseases)

1988: Hepatitis E virus (hepatitis E)

1993: Sin Nombre virus (hantavirus pulmonary syndrome)

1995: Kaposi sarcoma herpesvirus (Kaposi sarcoma)

1997: Transfusion-transmitted virus (transfusion-transmitted viral disease)

1998: Nipah virus (pig-borne; encephalitis and respiratory disease)

2001: Metapneumovirus (respiratory viral illness)

2009: Influenza H1N1 (pandemic influenza)

2011: Huaiyangshan virus (hemorrhagic fever-like illness)

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