Jacques Leibowitch (1 August 1942 – 4 March 2020) was a French medical doctor and clinical researcher known for his contributions to the knowledge and treatment of HIV and AIDS, starting with his initial designation of a human retrovirus as the cause of AIDS, and his ground-breaking use of triple combination therapy for the effective control of HIV in the patient. A practicing physician in the infectiology department of the Raymond Poincaré University Hospital of Garches (directed by Prof. Christian Perronne, AP-HP), University lecturer Emeritus, he led the treatment program ICCARRE that proposes a dramatic reduction of weekly anti-HIV drug intake, down to 2-3 anti-viral pills a day taken 2 to 3 or 4 days a week, as opposed to the presently recommended seven days a week, as still universally prescribed. These reduced medical dosages are adequate, necessary and sufficient according to the results of his exploratory clinical research carried out since 2003. He is the author of the books "Un virus étrange venu d'ailleurs" (A strange virus of unknown origin),Pour en finir avec le sida, Jacques Leibowitch, 2011, sur le site de l'édition Plon. Consulté le 1/10/2013 and "Pour en finir avec le sida" (Putting an end to AIDS)."Un virus étrange venu d'ailleurs", Grasset 1984
Biography Jacques Leibowitch was born into a Jewish family. He did his medical studies in Paris (1960–1968), and did his physician training at the AP-HP hospitals (1969–1979) where he majored in clinical immunology, notably at the Necker hospital under Professor Jean Hamburger. He acquired his initial experience in research in 1962 at the Bellevue Hospital of New York, later returning to the United States for a Post-doctoral research program at Harvard Medical School (Pr John David, Robert Brigham Hospital, Boston, 1970–1972), where he studied cellular immunology.Entretien avec Jacques Leibowitch réalisé par J.-F. Picard en mai 2001 sur le site histrecmed On his return to Paris, he finished his internship and went on to research Human Complement Biology at the Royal Hammersmith Hospital, London as post-graduate medical registrar (Pr Keith Peters, 1973–74), before undertaking his senior residency in nephrology at Necker, entering the Raymond Poincaré hospital at Garches as immunology assistant lecturer (1980). Jacques Leibowitch published many articles in international scientific journals.International scientific journals
Scientific and medical contributions The contributions of Jacques Leibowitch have marked the history of HIV and AIDS and their treatment:Les contributions de Jacques Leibowitch Pour en finir avec le sida, sur le site de Patrick Vallas. Consulté le 1/10/2013 In 1982, he expounded the hypothesis that an exotic CD4 trope retro-virus might be at the origin of the growing AIDS epidemic and put the Montagnier and de Gallo teams on the track of the virus From 1984 to 1985, he removed from the Cochin hospital blood transfusion center the HIV contaminated blood samples, using a test quickly developed under the urgency of the situation by Dr Dominique Mathez, Leibowitch's main collaborator at the Raymond Poincaré hospital at Garches, anticipating the large-scale screening tests. Leibowitch and Dr. Mathez developed a home-made biological assay system to measure precisely the levels of active virus in the patient before and under treatment, demonstrating the both meager and transient effectiveness of the antiviral AZT as monotherapy. He is the father in Europe of the first anti-HIV treatments combining three anti-viral molecules (tri-therapy treatment) for the long-term control of HIV in the correctly treated patient. From 2003 to 2014, he showed that after a minimum 6-month period on conventional 7-day-a-week "attack" treatment, weekly anti-viral drug intake could be reduced by 40% to 80%, while maintaining optimal control over the patient's HIV.
Discovery of the HIV retro-virus Jacques Leibowitch was at the center of the research on AIDS since the original outbreak of the epidemic, from the very moment when the investigation on its causative agent was launched. When the first series of AIDS cases in the United States were published in the New England Journal of Medicine and the Lancet in December 1981, Leibowitch noticed the similarity between the cases described in the United States and the historic case of a multiple-opportunistic infection syndrome in a Portuguese resident in Paris who had spent time in Angola and Mozambique between 1973 and 1976. He was then contacted by Willy Rozenbaum in March 1982 to set up the informal French Working Group SIDA, a self-nominated body to analyse the cases appearing in France.
When in July 1982, the first cases of AIDS appeared in hemophiliacs receiving highly filtered blood samples, the scientific community realized that AIDS was most likely caused by a virus. Jacques Leibowitch noticed some intriguing similarities between AIDS and the pathology linked to HTLV (Human T Cell Leukemia Lymphoma Virus), the only known human retro-virus at that time. Both situations affect CD4 T helper lymphocyte cells. HTLV induces the massive proliferation of one or several clones and their cancerization, whereas the other virus, the HIV virus tends to eradicate these cells without apparent discrimination.Un entretien avec le Docteur J. Leibowitch, Le Panorama du médecin n°1507, 8 octobre 1982 Otherwise, these two pathological descriptions are present in both Africa and the Caribbean (see A Strange Virus of Unknown Origin Jacques Leibowitch, Ballantine Books, New York, 1985, translated from Un Virus Etrange Venu d’Ailleurs, Grasset Paris 1984). Indeed, in both Paris and Brussels, doctors had seen cases of patients having lived or spent time in Francophone Africa or in Haiti who suffered from a disease with an undeniable resemblance to that arising at the time in the United States in "immuno-deficient homosexuals". Leibowitch, informed by the Franco-American literary author Gilles Barbedette of the announcement by Robert Gallo in Medical World News (1 August 1982) that an HTLV type retro-virus could be the cause of AIDS, found in that most succinct brief the profile matching his CD4-tropic exotic viral suspect (in Grasset, Ballantine Books, works cited). The retro-viral inspiration was thus consolidated and opened between Bethesda (Gallo) and Paris (Leibowitch et al.) from August 1982 onwards. Failing to find in the Paris team of Professor Jean-Paul LévyEntretien avec Jean-Paul Lévy réalisé par Anne Lévy-Viet&Jean-François Picard, janvier 1992-décembre 2001, paragraphe "Mais vous-même, vous aviez reçu la visite des cliniciens à Cochin" sur le site histrecmed or the Lille team of Dominique Stéhelin a French retro-virus specialist eager to pursue this line of investigation, he contacted upon a recommendation by Jean Paul Lévy Professor Robert Gallo in Bethesda, the then world-renowned virologist on HTLV. It was then in November 1982 that Gallo informed him from Bethesda of his initial virology findings in keeping with the AIDS HTLV-type virus hypotheses. For his part, Willy Rozenbaum, warned in private by Leibowitch that an exotic HTLV-type retrovirus could well be the cause of AIDS, embarked upon a discreet collaboration with the Luc Montagnier team of the Pasteur Institute. Montagnier, along with his collaborator Jean-Claude Chermann, had just recently received news of the HTLV and AIDS hypotheses by Dr Paul Prunet, the then director of « Recherché & Développement » at Sanofi-Pasteur-Marnes La Coquette, where Leibowitch had given a speech at the end of November 1982.Paul Prunet,Comprendre la vie et ou comprendre les maladies. Avec petit retour sur l'histoire de la recherche sur le sida en France sur le site de Patrick Valas The Montagnier team subsequently detected in the cell culture of patient BRU the traces of the first non HTLV retrovirus in January 1983, a virus eventually recognized as the cause of AIDS thanks to the conclusive additions by Robert Gallo and his group (April 1984) Memo Regarding Chronological Summary of Experiments Leading to the Isolation of HTLV-III from AIDS and ARC sur le site de la Jon Cohen AIDS Research Collection, 2 pages. Luc Montagnier and Françoise Barré-Sinoussi received the Nobel Prize for Medicine in 2008 for their work. In a letter to the prestigious magazine Nature Medicine in 2003, as well as in his Nobel Prize acceptance speech in 2008, Luc Montagnier recognized Jacques Leibowitch as being the initiator of the retro-virus hypothesis in France.Luc Montagnier, 2003, Historical accuracy of HIV isolation, Nature Medicine 9Luc Montagnier, Nobel lecture, 2008 However, the patented list of the discoverers of AIDS and HIV do not take Jacques Leibowitch into account for his contribution in the initial phases of the discovery. The scientific historian Mirko Grmek reflects back on the details of the stages that led to the discovery of the AIDS virus in his work "the History of AIDS" and the Jon Cohen AIDS Research Collection contains numerous archived documents on the subject. The book "Sida.O" (AIDS.O) written by D. Lestrade and G.Pialoux contains also many details on the history of AIDS.Didier Lestrade et Gilles Pialoux, Sida 2.0, Regards croisés sur 30 ans d'une pandémie
Detection and elimination of HIV-positive contaminated blood at Garches and at Cochin In 1984, while Luc Montagnier was working at the Institut Pasteur on an industrial test for HIV antibodies, Dominique Mathez and Jacques Leibowitch were working at Garches to elaborate a working test on tumour cells infected by the HTLV-III given to them by Pr Daniel Zagury at Paris University on behalf of Robert Gallo. Using this craftsman test, Mathez and Leibowitch discovered a disturbing frequency of individuals contaminated by the retro-virus amongst the polytransfusion recipients, and later, in collaboration with Dr François Pinon, head of transfusions at the Cochin hospital, go on to discover, the alarming proportion of HIV positive blood donors (1 in 200) in a pilot study carried out on donors in the Paris and Ile-de-France area. The health authorities were alerted on this issue together with their dramatic consequences for hemophiliacs (« if the Cochin Hospital study is correct, then all anti-hemophiliac stocks are contaminated … », Jean Baptiste Brunet at the French General Directory on Health, Mars 1985 13Retour sur l'affaire du sang contaminé par Catherine Manuel et Pascal Auquier, 1/06/1996, site de La recherche ). It was thanks to this artisanal test that 50 HIV positive blood donations, established then to be 100% contaminating, were taken out of the transfusion process, and 150 potential receivers of this blood were protected from contamination.Le procès du sang contaminé. 5e jour par Eric Favereau et Armelle Thoraval, Libération le 17/02/1999
Measure of viral levels in patients and evaluation of the effectiveness of treatment