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Winter 1999

The Scientist and the Cure
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On a shelf in one of Giorgi's labs is a collection of thick blue notebooks. They date to 1984, when she and her colleagues began drawing blood samples from 1,637 gay men. Filled with pages of T-cell counts and other measures, they record the sobering history of the AIDS epidemic. Of the 962 men who were infected, 584 have died of AIDS, 27 of other causes. Some 351 remain, as well as hundreds of uninfected men still involved in the study. For Giorgi, their cellular histories have provided crucial insights into HIV.

Giorgi's research focuses on understanding the specific function of immune cells and how they protect against HIV. This is not a straightforward task. The immune system is extremely complicated; in defending against disease, it has an amazing ability to distinguish between which invaders are a mere nuisance and essentially harmless and which are potentially lethal. In HIV, the immune system relies on various T-cells, including CD4, so-called helper T-cells, to fight the virus. It also provokes the activity of CD8 cells, or killer T-cells, which attack HIV and produce agents that prevent the virus from replicating. The importance of these killer cells in the immune system's war against HIV can't be overstated. As one of Giorgi's colleagues once remarked, "Without CD8 cells, we're toast."

While most AIDS researchers were focused on the virus itself, Giorgi believed the immune system held vital clues to protection against HIV. Some individuals, for example, become sick and die within months of infection, but most people can live with the virus for 10 years before their immune systems finally collapse. And a small number of people, despite repeated exposures to HIV, have yet to become ill even after 20 years.

Observing this pattern, Giorgi was intrigued. What was making the difference? At the time, searching for clues in the immune system wasn't a conventional approach. The money and glamour in AIDS was concentrated in virology, not in the quagmire of immunology. But Giorgi didn't much care about conventional approaches. Using the state-of-the-art process of flow cytometry, which sorts and counts cells with remarkable precision, Giorgi was able to show that CD8 cells were a potent force in protection against the virus. It was a landmark discovery.

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