The desire to treat people living with HIV grew from Joe Eron’s first inpatient rotation as a medical student in the early 1980’s.
“There was this young man who was so sick and we did not know what was wrong with him,” Eron recalls. “I was struck by two things. First, it was such a complicated case. We would get one thing under control and something else would flare up. And second, this man’s partner was so devoted to him, remaining by his side constantly. This man died of what we now know is AIDS. He and his partner left such an impression on me. I desperately wished we had known more about HIV at that time so we could have saved his partner’s life.”
Thirty years later and Eron has helped save countless lives as an HIV clinician-researcher. He is a Professor of Medicine in the Division of Infectious Diseases at UNC and the Director of the UNC Center for AIDS Research (CFAR) Clinical Core. The North Carolina Community AIDS Fund bestowed its outstanding achievement award to him this spring in recognition of “outstanding individual effort and personal sacrifice” for serving “in a variety of roles helping individuals in NC who are HIV positive and living with AIDS.”
“The North Carolina Community AIDS Fund Red Ribbon Award was given to Dr. Eron in celebration of the 20th anniversary of his New England Journal of Medicine paper that was published on the first combination therapy study with AZT/3TC in treatment naive patients,” says Bruce Curran, member of the NCCAF Advisory Board. “That publication was one of the major turning points in the fight against HIV/AIDS.”
From Consultant to Primary Care Provider
Eron knew early in his medical training he wanted to combine his passions for science, problem solving and caring for people. He decided to specialize in infectious diseases at after completing his residency at the Massachusetts General Hospital and two years in the Indian Health Service in Zuni, New Mexico. His interest in infectious diseases was tempered by the fact that the role of the ID clinician was that of a consultant with patients often returning to their referring doctor for care. HIV changed all of that.
“The discovery of HIV shifted the role of infectious diseases clinicians to that of primary care providers for people diagnosed with the virus,” Eron says. “After diagnosis, we would manage their care, which was ideal as we were keeping on top of the latest drug discoveries to treat the virus and its opportunistic infections, including a deadly fungal form of pneumonia.”
During his fellowship in infectious diseases at Massachusetts General Hospital, Eron met Martin Hirsch, MD, who was one of the first people to study HIV in the lab. At this time, AZT, the first antiretroviral therapy or ART, was being given to patients. As side effects for AZT became apparent and patients stopped responding to the medication, Eron focused on studying the drug’s resistance.
“I really enjoyed the work in the lab, but I missed being with patients,” he remembers. “Once I completed fellowship, I looked for a job where I could make a difference from the bench to the bedside. I wanted to continue treating patients, but also conduct research that would inform clinical care and save lives.”
The Road to UNC
Eron interviewed with Martin Blaser, MD, then Chief of Infectious Diseases at Vanderbilt University. Blaser asked him where else he was interviewing and Eron mentioned he had an upcoming interview at UNC.
“I told Marty, ‘I will take this job at Vanderbilt and cancel with UNC,’” Eron recalls. “But he told me to go and interview with UNC first and then make a decision.”
Eron traveled to Chapel Hill and met Myron Cohen, MD, Chief of the Division of Infectious Diseases. Cohen offered to drive Eron back to the airport. It was during this drive that Cohen made the case for choosing UNC.
“I parked for two hours in the no parking zone at the airport to make my case because I thought UNC was a better fit for Joe’s career,” Cohen says. “We had more faculty committed to HIV research and we had a global reach with the establishment of UNC Project-Malawi. I wasn’t trying to steal him from Vanderbilt. I knew that door was open, but I felt UNC was the most appropriate choice for his career.”
Eron accepted a position directing UNC’s Infectious Diseases Clinic in 1992 and has built an accomplished clinical care, research and teaching career at Carolina ever since. His first clinical trial led to a groundbreaking conclusion – combinations of antiretroviral therapy worked better than single-drug treatment. Patients stopped dying. The results were published in the prestigious New England Journal of Medicine.
“Combination therapy is when things really started to change for ID clinicians,” Joe says. “We went from being end-of-life-care advocates – helping patients tell their loved ones they were dying, or sometimes staying with them as they died alone – to giving them a new outlook on life.”
The 20th anniversary of this discovery and the impact it has had on the field is what prompted the North Carolina Community AIDS Fund to honor Eron.
“Joe has been a huge force worldwide in terms of intellect, compassion and leadership skills,” Cohen says.
Now that therapy with minimal side effects exists, Eron is seeking answers to the next big question – how do you return people living with HIV back to complete health? Although people living with HIV live longer lifespans than those diagnosed before effective antiretroviral therapy, their lives are still cut short when compared to people who do not have the virus.
“We have so many theories about this – are the meds not good enough? Should we start antiretroviral therapy sooner? Is the immune system too damaged by the virus to be repaired?” Eron asks. “We need to understand how to fully restore the immune system. There’s no textbook on how to do this. But at UNC, we’ve assembled a team that understands the biology of viral latency, study design and clinical care. It will take a village, but it can be done.”