Julio Montaner’s medical breakthroughs have helped save millions of
lives. Many were inspired by one simple piece of advice from his father.
Dr.
Montaner’s dad was a noted pulmonary specialist and expert on
tuberculosis, which was a problem in their native Argentina. Julio
Gonzalez Montaner told his son to treat the stubborn respiratory disease
with a combination of drugs – one alone was not enough.
The younger Dr. Montaner leveraged this concept in the mid-1980s
when, as a pulmonary specialist himself, working at St. Paul’s Hospital
in Vancouver, he kept encountering patients suffering from a previously
rare form of pneumonia.
He hypothesized that while these patients
seemed to have suppressed immune systems, their immunity was also acting
erratically – they had inflammation, too. He treated them with steroids
to curb the inflammation, then antibiotics to zap the pneumonia
infection. It worked.
As it became clear that these patients were
also suffering from an underlying new disease that would eventually be
labelled HIV/AIDS, Dr. Montaner went to a conference in California and
shared his discovery. His approach quickly became the standard of care
for pneumocystis pneumonia, which often affected people with HIV/AIDS.
Years
later, as head of the hospital’s AIDS clinic and research program
(launched in the late 1980s with Dr. Montaner as the only devoted
employee, plus a half-time secretary), he realized his father’s golden
rule might work again.
Dr. Montaner was treating his patients with
azidothymidine (AZT), but it wasn’t slowing the disease enough, and the
drug kept becoming resistant to the powerful virus. “Using the
combination model, I started shopping around for another drug,” says Dr.
Montaner. He began testing his patients with a combination of AZT and
didanosine (DDI). Better, but not good enough.
Diane Peters
The Globe and Mail
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