‘Psychosocial behavior’ a key to HIV treatment.
HIV/AIDS is no longer a death sentence. Just ask Dr. Eric Daar. “I’ve been treating HIV/AIDS patients since very early in the epidemic, when we spent most of our time just helping people die comfortably, until now, a period when we’re giving people hope. The majority of our patients hope for a long, healthy life,” said Daar.
Dr. Daar is chief of HIV Medicine at L.A. BioMed, practicing at Harbor-UCLA Medical Center in Torrance. This Palos Verdes resident, Southern California native and Georgetown University grad also works at Harbor as an investigator of medicine and teacher, and is a professor of medicine at Geffen School of Medicine at UCLA. “Too many titles,” he said with a laugh. Daar completed his residency and fellowship in infectious diseases at Cedar Sinai, served on the faculty and became chief of infectious diseases at Cedar. His tenure at Harbor “is about 10 years.” Los Angeles Biomedical Research Institute is acknowledged to be among the nation’s leading nonprofit facilities in health studies. In addition to research, L.A. BioMed trains young scientists and provides community services in most areas of health care.
Day by day
During a traditional work day, “I’m engaged in patient care. We have a clinic here at Harbor-UCLA campus where we take care of about a thousand people who have HIV, and then we have another clinic in a county-funded comprehensive care center in Long Beach, where we take care of about 250 patients. I’m involved in the direct care of these patients plus the teaching of our infectious disease fellows about HIV medicine” said Daar.
“In addition, in the afternoons I see patients admitted to the hospital who have HIV, most of the time, but occasionally with general infectious diseases where I depend on the consult service.” With the consult service, Daar said his staff sees every patient admitted to the hospital, regardless of what brought them to the facility. He teaches the fellows about managing HIV in-patients. “The nice thing is that when we have these patients in the hospital, we get to know them very well and, when they’re ready for discharge, they’ll often come back and see us in the clinic,” said Daar.
Harbor deals with what he calls a “challenged population. We take care of a lot of indigent, poor, immigrant patients, but we’re able to increase the likelihood that they will come back and improve with continuity of care. HIV care is really among today’s miracles of modern medicine in that we can take people who we meet in the emergency room who are diagnosed with advanced AIDS, get them through their complications and get them into clinic and then completely give them their lives back,” he said.
Initial involvement in HIV care
Part of Daar’s interest in HIV/AIDS stemmed from growing up when the disease first emerged. “I was in medical school when HIV/AIDS was first prescribed in Washington, D.C., when I was at Georgetown. Then it really began to explode in the years of my residency,” said Daar.
“During my training I started working in a research laboratory and became increasingly engaged in clinical research. It was interesting to be involved in something so new, at the very earliest stages, that was clearly to become something really big. And, I think I was attracted to it because it involved people who were my peers who were mostly my age. We were dealing with this life-changing diagnosis and early death.”
Though the care and treatment of HIV is making great gains, Daar’s research continues.
“When I’m not dealing with patients,” said Daar, “we have a pretty large research program where we are doing everything from trying to understand why HIV causes disease, which includes everything from immune suppression – which is what most people think about – as well as a large program studying the affect HIV has on the brain, which we know is another major target for HIV infection.”
He also said there are current programs linking HIV and its treatment to other organs in the body, including the heart, liver, kidneys and bone. “We have studies on how to treat HIV itself; what are the best, safest and most tolerated of combinations, or cocktails, of drugs that can be used to help patients completely control the virus to live a normal, healthy life,” said Daar.