By then, Dr. Waldmann already had spent 25 years at the National Cancer Institute studying human immune deficiencies. His laboratory had made significant contributions to our understanding of how the immune system works and how it goes awry. When a 35-year-old man was referred to the NIH Clinical Center with multiple infections and a dangerously low white blood cell count, Dr. Waldmann and his fellow physicians tried to determine what was wrong. “We drew together a great number of individuals from the NIH community,” he comments. “We were all groping, trying to understand what was going on.” When, shortly after the man’s arrival, the first report of a new immunodeficiency disease in gay men was published by what was known then as the Centers for Disease Control, this helped them put the pieces of the puzzle together.

Although AIDS was still an unknown entity, Dr. Waldmann and his colleagues began to reveal some key features of the disease. “Even in that era before AIDS, one recognized this pattern of infections as the hallmark of a cell-mediated immune defect,” says Dr. Waldmann. By applying his years of research on immune function to this patient, he began to define the T- and B-cell abnormalities that would prove to be consistent features of AIDS.

Dr. Waldmann reflects on the AIDS epidemic with the insight of someone who has spent 45 years at the NIH. He currently is chief of the metabolism branch in NCI’s Division of Clinical Sciences.