At a research clinic in Thailand, study participants became familiar faces during twice-weekly visits for blood draws. The volunteers had self-identified as being at high-risk for HIV infection, but they hadn’t tested positive. During the course of the study, some participants became infected with the virus. The frequent blood tests indicated that they were in the throes of acute HIV infections, yet they otherwise appeared to be in good health. No symptoms to speak of.

The scientists, including Colonel Robert J. O’Connell (MD ’97), were surprised. Previously, it was thought that people experiencing an acute HIV infection would present with clear symptoms. The team published its Thai clinic results, as well as results from clinics in East Africa, in the New England Journal of Medicine in 2016. “It was the very first time that [we] had the ability to so very carefully characterize what the virus was doing in the very beginning of human infection,” O’Connell says of the study.

Inventing an HIV vaccine—and even a cure—was a primary assignment for Colonel O’Connell in his former role as director of the Armed Forces Research Institute of Medical Sciences (AFRIMS). The institute in Bangkok began when American and Thai armies worked together to stop a cholera epidemic in the 1950s. The partnership has grown into finding cures for infectious diseases that are of particular concern to soldiers. “When we do that and are successful, we generate products or knowledge that have broader public health benefits,” he says.

As he served in this role, the military and civilian scientists in his circle studied not only HIV, but also malaria, dengue, and other tropical infections. He regularly travelled throughout Asia to oversee research projects in Nepal, Cambodia, and the Philippines and to speak at expert exchanges with military health services in such locations as China, Myanmar, Singapore, and Malaysia.

In July, O’Connell moved on to a new assignment: deputy commander of the parent organization of AFRIMS, the Walter Reed Army Institute of Research in Silver Spring, Md. “We conduct infectious disease and brain health research,” he says. His new e-mail signature reflects the broader impact of his work: “Soldier Health. World Health.”

O’Connell, born and raised a Minnesotan, earned his Pitt MD with assistance from the military’s Health Professions Scholarship Program, then trained in infectious diseases and internal medicine with the U.S. Air Force Medical Corps in Texas. His research career began at Walter Reed. He became chief of the Department of Retrovirology at AFRIMS in 2013.

Today, AFRIMS has a partnership with Pitt, O’Connell notes with pride. The institute is working with John Mellors, who holds Pitt’s Chair for Global Elimination of HIV and AIDS, to investigate an immunotherapy treatment for HIV that involves removing a patient’s cells, priming them for a fight, and returning them to the patient’s body.

When O’Connell reflects on his Pitt days, he says that on a practical level, he is most grateful for the medical training that guided him as a battalion surgeon during a one-year deployment to Iraq beginning in 2009. He’s also thankful that he attended a university with legends who continue to inspire his work.

O’Connell remembers listening to talks by Jonas Salk as a visiting lecturer and Bernard Fisher on his first day of med school. “Jonas Salk pursued a product—[the polio vaccine]—that tangibly made an enormous impact on the world,” he says. “On the other hand, Bernard Fisher made an enormous difference in the lives of countless women [by conducting clinical trials on breast cancer treatments]. He used evidence-based medicine to change the world.”

O’Connell hopes to do both—develop products and gather evidence for the best ways to defeat infection.

 

Photo: Puwanai Sangsri/Armed Forces Research Institute of Medical Sciences.
Photo illustration: Elena Gialamas Cerri 

https://www.pittmed.health.pitt.edu/story/defeat-infection