Emeritus Faculty Association news November 2012

Next Meeting:
Friday November 2nd, 10.30am Javits Room, 2nd floor library. Charlie Backfish and Mel Morris from the early days of Stony Brook will speak of those times. Since they welcome a Q&A session we might also use the opportunity to learn their take on the current political debate about US schools and the efforts to improve them.
Bios:
Charles Backfish was a member of the first USB graduating class where he received the B.A. in History in 1966. He went on to further study at NYU, and then to teach social studies at Smithtown High School, teaching A.P. US history and creating an interdisciplinary American Civilization course. Following his retirement from Smithtown in 1999, he joined USB as a lecturer in history where he has served as Director of Student Teaching in the Department's Social Studies Education Program. In June of this year he received the first Provost's Outstanding Lecturer Award. He also edits the on-line Long Island History Journal and is the host (since 1978) of an acoustic music program on WUSB-FM. He served on the alumni association board from 1991-1998 and was president from 1997-1998.
Melvyn Morris is a founding member of USB where he received his BS in Biology. He also has advanced degrees in Marine Science and Education from CW Post and Univ. of Florida. He was the first science faculty hired to start Shoreham-Wading River high school and retired after 24 years during which time he helped to shape the science program, developed the community education program, was a class advisor, and was active in the teacher union. After spending 2 years at Southampton College he then joined Brookhaven National Laboratory as an administrator in the Office of Educational Programs. He is responsible for student internship programs, started the successful Open Space Stewardship Program, and organizes teacher workshops. He was president of the USB alumni association for 7 years.

Last Meeting:
Retirees who are medicare-primary: You will receive notification about an improved Medicare Part D prescription drug program that has been expanded to provide a benefit level "generally as good as or better than The Empire Plan" (possibly including an announcement letter with a "mandated Cancellation Form"). Do not send in any cancellation form! If you do nothing, be assured that you will still have your prescription coverage, although Empire may raise your copay rates in January (Judy Wishnia).

Scheduled Talk: Roy T. Steigbigel, Distinguished Service Professor, Medicine, Pathology Pharmacology and Microbiology (see bio last issue), was introduced by Martin Leibowitz.
Simian immunodeficiency virus (SIV) probably entered humans in the 1930's in Africa through cuts while they were butchering the animals, and then mutated into a form that could infect humans. The acquired immune deficiency resulting from the human form of the virus was not recognized until 1981 (Gottlieb). In 1984 the CD4 protein cluster on the surface of white blood cells used by HIV for entry was discovered, thereby making possible the monitoring of the progress of the HIV infection and the screening of transfusion blood. As of 2009, worldwide there were 33 million people living with HIV with 2.6 million new diagnoses and 1.8 million deaths per year. Outside of Africa, known infections are currently highest in Eastern Europe and Latin America. As for developing nations like China we simply do not know. While the disease has peaked in the US, prevalence is greatest among afro-americans and in the states of CA, NY, FLA, and PR.
CD4 is a classification name of a protein cluster on the surface of some lymphocytes (white blood cells). HIV most often infects CD4 cells. It attaches to the CD4 receptors, allowing the virus to enter and infect the cells and damaging them in the process. The virus then becomes part of the cells and when they multiply to fight an infection, they make more copies of HIV. The fewer functioning CD4 cells, the weaker the immune system, and therefore the more vulnerable a person is to infections and illness. HIV is in fact the only pathogen to insert itself into the genome. But it lacks proof-reading enzymes to correct errors made when it converts its RNA into DNA. The short life-cycle and high error rate cause the virus to mutate very rapidly (billions of variations each day). This results in the high genetic variability of HIV and rapid development of resistance to many drugs. So in some ways HIV is the perfect pathogen. It attacks the very cells nature has provided to combat it, and it uses the cell material for its own reproduction. No drug is known that can cure HIV/AIDS. So combinations of drugs have typically been used to create multiple obstacles to HIV replication, keep the number of offspring low, and reduce the possibility of a superior mutation. In theory if a mutation that conveys resistance to one of the drugs arises, then the other drugs continue to suppress reproduction of that mutation.
In the last few years new drug possibilities have emerged which show promise of improving the situation. For example integrase inhibitors target an HIV enzyme that integrates the viral genetic material into human chromosomes, a critical step. There are several integrase inhibitors currently under clinical trial, and Raltegravir (which Prof Steigbigel was instrumental in developing) became the first to receive FDA approval in October 2007. His study found that when paired with other anti-HIV medicines, the drug effectively lowered the amount of virus in the blood to undetectable levels in 62 percent of the patients, versus 33 percent of the patients receiving placebo plus other anti-HIV medicines. Research being done to identify new vulnerabilities of the HIV entry process could also provide insights for other diseases.
If testing becomes more widespread, especially among partners, the spread of the disease could be greatly reduced. In the Enzyme-linked immunosorbent assay (ELISA) test, if antibodies to HIV are present (positive), the test is usually repeated to eliminate the false positives (1/1000). The test has an almost zero chance of having a false negative after the first few weeks that a person is infected. In that case other tests are not usually needed. Coincidentally, on the same day as our talk, the NY Times announced that the first rapid self-testing kit has just gone on the market for $40. See: http://www.nytimes.com/2012/10/06/health/another-use-for-home-hiv-test-screening-partners.html?pagewanted=all .
Audience questions brought out the subject of drug development. Prof Steigbigel said that for every 5000 preparations of a medication only about 2 get to be marketed for patient use. So the costs of development are enormous and we definitely need the drug companies. On the other hand while the companies may be keen to develop drugs such as those above which have to be taken for the rest of the patient's life, their enthusiasm is less for antibiotics that the patient uses for just one week. The result has been that in a time of decreasing effectiveness of current antibiotics for various reasons, the companies have developed only two distinct new types in the last 10 years! For this reason a move is now afoot to have the NIH take a more active role in antibiotic development.