HIV/AIDS research expert shares his path to research and what’s ahead, as Dec. 1 marks World AIDS Day
By Jon Weiner
Michael Silverberg, PhD, MPH, is an infectious disease epidemiologist with a special interest in HIV. His work involves the design and analysis of studies evaluating long-term health outcomes for persons with HIV. He is also involved in studies of other chronic infections including hepatitis and human papillomavirus.
Q: If you had to think back, is there a single moment in your life that sparked your interest in what you’re doing now?
I was a teenager growing up in the 1980s in Los Angeles. That was the decade that the world first became aware of a new deadly disease, AIDS, with no good options for treatment or prevention. Los Angeles was also home to the NBA’s “Showtime Lakers,” my favorite team. In 1991, I was devastated to see my favorite player from the Lakers, Magic Johnson, announce on TV that he had AIDS and was retiring from basketball. That moment certainly sparked my interest in learning more about HIV/AIDS, and infectious diseases in general.
Q: Given your area of expertise, what should people know about their health that you don’t think they know?
There is currently no vaccine available to prevent people from becoming infected with HIV, although this is an active area of research. However, the same HIV medications being used by people with HIV can be taken by people without HIV who are at high risk for getting infected. Research at Kaiser Permanente demonstrated that such an approach is highly effective with no new HIV infections among those that consistently took their medications.
Q: What kind of research are you doing and why do you think it’s important?
A lot of my work has focused on long-term health impacts of being infected and taking lifelong treatments. People with HIV tend to have a higher risk of developing other chronic diseases, including many types of cancer, cardiovascular disease, liver disease and kidney disease. My research has focused on disentangling the many reasons for these patterns, including direct effects of the virus such as the associated immunodeficiency and increased inflammation, potential adverse effects of treatments, and the higher risk of other traditional risk factors such as tobacco use, alcohol use or other coinfections.
The overarching goal of my research is to identify strategies to improve long-term health in this population. For example, some of my research involves investigating whether certain first-line HIV treatment regimens are better than others for preventing cancers, or cardiovascular disease. Another study is investigating ways to screen for and reduce impacts of alcohol and substance use in HIV patients.
Q: December 1 is World AIDS Day. How has AIDS/HIV care changed over the decades? Where do you see it headed in the future?
There have been tremendous improvements in HIV treatments over the years. Prior to 1996 and the introduction of protease inhibitors, a diagnosis of HIV was considered a death sentence. Even after 1996, people with HIV had to take dozens of pills a day and they were very toxic. Nowadays people can take just a single pill a day and the medicines are much better tolerated. The HIV medications are so effective that people who take them regularly are no longer infective to others. The drugs are also being used in people without HIV to prevent them from getting infected during times of high risk. This is good news for those with access to health care and treatment.
Q: In your free time, what do you like to do?
Most of my free time involves traveling, game nights, movies or just enjoying the company of my wife and two sons. I also continue to enjoy watching and playing basketball. While I have passed on the love of basketball to my two boys (including one who is a hardcore Lakers fan), I have yet to spark their interest in infectious disease research!
For more on Kaiser Permanente research into HIV/AIDS, see this Research Brief.