[PROFILE] Dr. David Ho (AIDS Researcher)
- THE TAO OF HO
BY HOWARD CHUA-EOAN
DECEMBER 30, 1996/JANUARY 6, 1997 VOL. 148 NO. 29
If you lean in close, conspiratorially, Sonia Ho may just let slip a
secret she keeps about her son David. She will speak in a hush, as
if to elude some spy's eavesdropping from behind the potted palm.
But she badly wants to divulge her information. Thus, slightly
abashed but nonetheless proud, she will confide, "He's kind of a
genius, you know. I'm not supposed to say that, but it's true."
Mothers are allowed to say these things. But one doesn't have to be
David Da-i Ho's mother to be aware of his brilliance. He lays forth
clearly and succinctly some of the boldest yet most cogent
hypotheses in the epic campaign against HIV; at the same time, he
operates nimbly through the budgetary and political pitfalls of the
enterprise. And though he is monumentally tranquil in demeanor, he
has been known to fling the occasional hot one-liner against
naysayers--once, "It's the virus, stupid!" to those who insist HIV
is not the cause of AIDS.
Genius, however, is a word that originally referred to a guardian
spirit. Ho cuts too slight a figure to qualify as a force of nature,
but his spirit is startling: a fierce competitiveness that is
manifested as a subtle calm, a passionate transcendence. It is
evident in his gestures. His fine-fingered hands do not punch out
arguments; rather they escort logic through tangles of confusion,
gently prodding reason his way. Perhaps Sonia Ho is right to be
hushed, for her son's genius emanates from the depths of his
family's experiences, and it is not quite Asian to make a display of
one's legacies. But she is also right to be proud, for this is
America, and her son is an extraordinary American success story.
TIME's 1996 Man of the Year was born in Taichung, Taiwan, on Nov. 3,
1952. At birth, he was given the name Da-i, two Chinese ideograms
that literally mean "Great One," a Taoist term of vast cosmological
consequence. It is a name reflecting great expectations. Taichung,
however, was a quiet town in the Taiwan boondocks, and the Ho family
lived in a modest four-room house with a backyard ditch that served
as a toilet and from which farmers collected fertilizer for their
fields. To forge a better life for his family, Ho's father took ship
in 1956, traveling 18 days on a freighter to America. For nine
years, Da-i would know his father only through letters and parcel
For Da-i and his younger brother, the years of waiting were filled
with long school days that included, after a quick stop at home for
dinner, a 20-minute bike ride to a cram school for extra tutoring.
As they rode home in the dark through the empty countryside, the
eerie sounds of frogs and crickets would sometimes scare the
brothers into frenzied pedaling. Street stickball was a welcome
interruption. And whenever he could, Da-i would sneak off to the
neighborhood store to leaf through comic books.
When his father sent for the family, a seriousness came over Da-i.
The 12-year-old packed his own bags and stayed awake throughout the
flight to watch over his mother and his younger brother. They were
traveling to a land they did not know and whose language they did
not speak. It would be a place where they would receive new names
and new identities. Their father, a devout Christian who now called
himself Paul, had picked the boys' American names from the Bible.
Thus it came to pass that Ho Da-i became David Ho and his younger
brother became Phillip. For a few more years, Phillip would refer to
David by the Chinese honorific for "older brother"; becoming
American would take time.
The family initially settled in a black neighborhood of central Los
Angeles, not far from the University of Southern California, where
Paul Ho pursued a master's degree in engineering. A translator for
U.S. troops in China during World War II, he instructed his wife
that their sons were to stick to Taiwanese and Mandarin Chinese and
not learn English until they got to America for a better chance of
speaking it without an accent. As Sonia Ho recalls in careful but
imperfect English, "When we first come to U.S., we don't know any
words. David would come home from school and say, 'I don't know what
they talking about.' I'd say, 'Oh, what are we going to do?'" Says
David: "We hadn't even learned the ABC's. I remember being laughed
at by classmates who thought I was dumb."
A diffident David did two things: he became an introvert and stuck
close to the family, and he focused on school and achievement. Says
Phillip, now a dentist: "He knew what it was he had to do." Sonia
recalls, "If he got even one question wrong, he'd be very upset with
himself." It was A's in everything, math, science--and English. Six
months after starting school, David settled into the language,
thanks to an English-as-a-second-language program and the miracle of
TV. "We watched The Three Stooges," Phillip says. "We picked up a
few phrases here and there and some mannerisms." When their parents'
third son was born, Phillip and David got to choose the name. They
skipped the Bible and picked Sidney, after a character in a Jerry
Medicine was David's second choice as a career. After high school,
he attended M.I.T. and Caltech as a physics major. He never let up
on himself, at work or play. Though short, he was an intense
basketball player. At Caltech, he took up chess. Characteristically,
the first time he entered a tournament, he won.
Ho soon realized that the most glittering prizes in science weren't
in physics. Molecular biology was the cutting edge, gene splicing
the hot technology. Medical research, says Ho, was much
more "tangible." And so he made his way to Harvard Medical School.
Soon enough, medicine provided the turning point of his career. His
mother recalls, "He told me he saw a lot of young people die. He say
that must be some disease, so he want to keep researching to find
out why." Ho had met up with HIV.
As he pursued medicine and then the virus, Ho's introversion
faded. "It took many years to reverse itself," Ho says. At the same
time, his brothers say, he grew less temperamental and developed his
legendary tranquillity. When colleagues threw a tantrum, Ho gently
offered advice from Chinese philosophers. One of his favorites is
the Taoist sage Lao-tzu, who said, "The softest things in the world
overcome the hardest things in the world."
The equanimity deepened as Ho carved out time for his family. Even
at school, he acted as a second father to his brother Sidney,
writing constantly with advice and encouragement. Says Sidney, who
now works for David as operations manager at the Aaron Diamond AIDS
Research Center: "He would take a late flight and get in past
midnight, but he would always come to my room and wake me up for a
brotherly chat." Ho became a father himself. He and his wife Susan
Kuo, an artist, have three children: Kathryn, 18, Jonathan, 15, and
Jaclyn, 10. Now and then, Ho sneaks away from his busy schedule to
surprise his kids at school. This fall, after his picture appeared
in TIME, he was invited to explain AIDS to Jaclyn's fourth-grade
As a child, Ho had his math tables drilled into him in Mandarin, and
to this day he does his calculations in Chinese. "But," he says, "I
wouldn't even have the vocabulary to give a scientific talk in
Chinese." He plays down the importance of being Chinese to his
success--but that is a very Chinese thing to do. Instead, he cites
immigrant drive: "People get to this new world, and they want to
carve out their place in it. The result is dedication and a higher
level of work ethic." He adds, "You always retain a bit of an
underdog mentality." And if they work assiduously and lie low long
enough, even underdogs will have their day.
--Reported by Dan Cray/Los Angeles, Alice Park/New York and Donald
Dr. David Ho, World-Renowned HIV/AIDS Researcher and Time
Magazine's '1996 Man Of The Year' to Serve as Senior HIV/AIDS
PR Newswire, 810 Seventh Avenue, New York, NY 10019 - May 1997.
LOS ANGELES, May 15 /PRNewswire/ -- Dr. David Ho, world-renowned
HIV /AIDS researcher, and Time magazine's "1996 Man Of The Year,"
will be senior consultant for the BENTLEY HEALTH CARE, Inc.
HIV /AIDS division. Dr. Ho has been internationally recognized for
his groundbreaking work with protease inhibitors, which in
combination with standard anti-viral medications has provided a
dramatic new direction for the treatment of HIV / AIDS patients .
BENTLEY HEALTH CARE, Inc. is the newly created global health care
company of Dr. Bernard Salick, the disease-state management
visionary and former Chairman and CEO of Salick Health Care, Inc.
Dr. Salick is highly acclaimed for his pioneering approach to
quality, cost-effective, state-of-the-art outpatient diagnostic and
treatment centers. He is credited with the development of innovative
concepts that have fundamentally altered the way cancer care is
delivered in the United States. He is also recognized as a leading
expert in managed care and disease-state management.
As Senior HIV /AIDS Consultant, Dr. Ho will provide BENTLEY HEALTH
CARE with strategic advice in the areas of practice guidelines,
outcomes measurements, and treatment protocols which will be used in
the development of a data base for capitated and other types of
managed care products. He will head up the HIV /AIDS scientific
advisory group that will advise Dr. Salick in the development of
affiliated networks of basic science and clinical treatment centers
throughout the world.
Upon announcing the affiliation, Dr. Salick stated, "I am very
pleased that a physician and researcher of Dr. Ho's stature and
accomplishments has decided to be a key member of the Bentley Health
Care consulting team and will provide such a critical range of
Dr. Ho, whose ingenious combination anti-viral "cocktail" treatment
has captured worldwide interest, has been performing landmark
investigation of HIV infection since the mid-1980s. His research has
produced a wealth of vital information on how HIV attacks and
eventually overwhelms the immune system . His experimental work,
alone and in cooperation with others, has expanded the frontiers of
knowledge regarding HIV and AIDS and opened exciting new directions
BENTLEY HEALTH CARE, Inc. is a Beverly Hills-based global health
care company that will provide diagnostic and therapeutic services
to patients with catastrophic illnesses requiring sophisticated long-
term care in cancer, AIDS, kidney failure, and organ
transplantation. It will also enter into negotiations with state,
federal and local governments both here and in Europe in the areas
of Medicare, Medicaid, Champas and other government health plans,
Managed Care and the E.C. Nation Health Service. The company is
dedicated to advancing the field of disease-state management,
offering innovative and unique solutions to patients, physicians and
payees seeking quality patient care and cost-effective disease-state
CONTACT: Ron Wise of Bentley Health Care, 310-248-3300
Dr. David Ho: A Scientist's Perspective
on the AIDS Epidemic
By Robyn Page
Dr. David Ho is the scientific director and chief executive officer
of the Aaron Diamond AIDS Research Center in New York City, and a
professor at Rockefeller University. He was named Time
magazine's "Man of the Year" in 1996 for his leadership in the field
of HIV/AIDS research. Vision contributor, Robyn Page, recently spoke
with Dr. Ho about the challenges facing scientists as they develop
new AIDS drugs and search for a vaccine.
RP You've been involved with AIDS since the beginning of the
epidemic over twenty years ago. Did you expect the epidemic to
unfold the way it has?
DH Absolutely not. I don't think anyone expected to have an epidemic
like the one we're facing. In those days it was an interesting
curiosity, something obviously new, something with scientific
importance. But no one could have imagined that this would turn into
a worldwide pandemic, one that threatens the entire world.
RP Did you feel a sense of helplessness as you watched the epidemic
DH Oh, for a long time. Despite identifying the virus, proving that
HIV was the causative agent of AIDS, developing blood tests, and
many other advances on the basic science front, there was a sense of
hopelessness because the patients continued to die with minimal
impact from our intervention. By 1986 or 1987, there was one drug,
AZT, which slowed the disease by only a few months, so the sense of
despair was pervasive. Really, it wasn't until more drugs were
available, by around 1994 or 1995 that a bigger impact was made.
That was the first time we had any hope that we could at least win
one battle against this virus.
RP The development of these antiretroviral drugs has dramatically
improved patients' quality of life, but now we're hearing reports of
drug resistance, which can potentially compromise their treatment
options. Why is drug resistance happening?
DH In an ideal world, if antiretroviral drugs are being properly
administered and there is proper compliance, the appearance of
resistance is uncommon. However, we live in the real world where a
lot of issues complicate adherence to a drug regimen. There is no
doubt that when you look at a population, in New York City for
instance, who are taking antiretroviral drugs, you will find
individuals harboring viruses that are resistant to one or several
drugs. These resistant viruses are capable of spreading in the same
way as the "wild type" virus [the most common form of HIV]. Just as
we have seen with antibiotic resistance, over time you will find
that a greater and greater percent of the circulating viruses are
drug resistant. Right now, only about five percent of the new HIV
infections are due to drug resistant strains.
RP Is there anything scientists can do to minimize drug resistant
DH Well, I think scientists could help in many respects. One way is
simply to come up with better antiretroviral drugs. More potent
drugs would help control the virus better and drugs with better
features could be taken once a day instead of three times a day,
which would help patients with adherence. Also, because these drugs
have side effects, scientists need to modify the drugs to retain
their effectiveness but remove the side effects. Then ultimately we
can come up with drugs that attack another target within HIV so that
viruses that are resistant to existing drugs would then be
completely sensitive to the new drugs. This is what we can do and in
fact such developments are being made as we speak.
RP Now that we've discussed some of the challenges faced in
developing antiretroviral drugs for treating people who are already
infected with HIV, let's discuss the development of vaccines for
preventing HIV infection. Why has it been so difficult to come up
with a vaccine for HIV?
DH Firstly, HIV is a different virus. It's in a family of viruses
that we have really not confronted before. Unlike many other viruses
we have dealt with in the past, HIV is particularly difficult to
inactivate by antibodies. Usually, the antibodies in the human
immune system are quite effective at controlling viruses by binding
to them and inactivating them. Our antibodies are not very effective
against HIV because much of the surface of HIV is composed of sugar.
This acts as a kind of shield, which prevents the antibodies from
attaching themselves and inactivating the virus. Our traditional
vaccines have been based on the introduction of specific antibodies,
for example polio or smallpox. But since HIV-specific antibodies are
not able to bind very well, they are not able to inactivate HIV very
well. So that's one huge problem confronting us.
Secondly, we are now forced to use vaccines that that produce a
different type of immune response, which we call a cytotoxic T-cell
response. These vaccines require a different method of
administration or delivery or overall vaccine strategy. We simply
cannot take the virus, kill it and give it as a vaccine as has been
done with other viruses. With HIV we have to come up with novel
strategies like DNA vaccines, line vector vaccines, which involve
new technologies that we have not used for other vaccines in the
And thirdly, and this is not necessarily a complete list, because
HIV has a very high mutation rate it's rapidly changing, so we're
not dealing with a single virus, we're dealing with a huge
population of diverse, yet related viruses. It just adds another
layer of complexity. What we need is a new approach to deal with a
RP Does HIV mutate more than other viruses?
DH There are many viruses that mutate a lot, but many of the viruses
don't continue to mutate day after day. So HIV not only has a
mutation rate, it also causes a chronic infection. Many RNA viruses
actually mutate quite a bit, but some of them only infect you and
replicate for a few days or a few weeks at most. HIV continuously
replicates for ten-plus years sometimes. In this respect, Hepatitis
C is similar. So HIV is not the only frequently mutating virus, but
it's certainly one of the most striking ones.
RP Realistically, how soon can we expect to see a vaccine for AIDS?
DH I think scientists are upbeat because there have been some recent
successes in monkey experiments. There is a greater concerted effort
to develop a vaccine now, but the timeline is long, because the
testing process is long. Let's say, for example, you have a very
good vaccine in your hands today. You would need to take it to the
FDA [United States Food and Drug Administration] for the initial
safety testing, and then do additional testing in people to show
that it would induce the kind of immunity you seek. Lastly, even if
you successfully overcame those hurdles, you would then have to
prove that your vaccine protects against HIV infection. So you would
need to take it to an area where the HIV infection rate is high and
compare your vaccine to a placebo. You would need to give the
vaccine to thousands or tens of thousands of people for one or
several years. So you can see the timeframe. Even if you had the
vaccine today, it would take about five years to prove it.
RP I've heard about a type of vaccine that would help boost the
immune system of HIV-infected individuals. How would this work?
DH There's a lot of talk of using a preventative vaccine to treat
infected people. Now, of course, it's probably pointless to
vaccinate while the virus is replicating and attacking the very
immune cells you're trying to stimulate. But now that we have better
drugs to control the virus, there's a school of thought that perhaps
we could control the levels of the virus with drugs and boost the
HIV-specific immunity with the vaccine. The hope being that this
would help control the virus someday without the use of drugs so
that the patient could discontinue using drugs. There are already
such experiments going on in people. It could be a reflection of
this being a first generation vaccine, but we've not seen a great
deal of success along that line. But it doesn't mean that we should
abandon the whole strategy should there be better vaccine candidates
For more information on the research being done at the Aaron Diamond
AIDS research center, go to http://www.adarc.org/