Conversations on with Dr. Carl Dieffenbach, NIAID


May 31, 2008

Q: Welcome to Conversations on I’m Ira Dreyfuss. Each month on we have conversations with government officials about HIV/AIDS issues.

Today we’ll be speaking with Dr. Carl Dieffenbach, the director of the Division of AIDS in NIH’s National Institute of Allergy and Infectious Diseases. Dr. Dieffenbach, welcome and thank you for joining us today.

Dr. Carl Dieffenbach: It’s my pleasure.

Q: What is the National Institute of Allergy and Infectious Diseases?

Dr. Carl Dieffenbach: The National Institute of Allergy and Infectious Diseases is one of the larger institutes at the NIH. Our primary mission on the Infectious Disease side is to support research on important diseases like HIV, TB, and Malaria and other infectious diseases that affect people in the United States as well as the world. On the allergy and immunology side, we’re involved in everything from food allergy to studies of asthma and rhinitis. The usual diseases.

Q: Allergy and colds?

Dr. Carl Dieffenbach: Allergy and colds.

Q: What is your role at the National Institute of Allergy and Infectious Diseases?

Dr. Carl Dieffenbach: I’m the director of the Division of AIDS. That’s one of the larger AIDS funding organizations in the world. We support research at all levels in HIV/AIDS research, everything from basic research—how the virus enters the cell, how it kills cells, to studies in people, clinical trials to how to prevent infection and how to help people who are living with AIDS survive and live a normal, happy life.

Q: Would you please give us an example of how the research that is being conducted at the National Institute of Allergy and Infectious Diseases helps people living with or at risk for HIV infection.

Dr. Carl Dieffenbach: Let me give you two examples. First for people who are infected with HIV. The United States government early on through its efforts at the NIH supported a large amount of drug discovery research that has led to the establishment of a very large pharmaceutical industry in this country and worldwide now that makes a large number of licensed antivirals or drugs that can prevent the virus from growing in your body. We at NIH have really pioneered the use of these drugs through clinical trials through unique combinations that really give people the best possible combinations to prevent their disease from progressing towards AIDS.

A second example is the use of antiretrovirals to prevent mother to child transmission. In this country, we have essentially eliminated the transmission of HIV from an HIV-positive mother to her child at the time of birth through the use of these drugs. Worldwide we have studies going on to try to make this an event, in terms of preventing mother/child transmission that occurs worldwide.

Q: What can public health officials do or continue to do to help people living with HIV/AIDS?

Dr. Carl Dieffenbach: From the perspective of the NIH, as a research funder and a research organization, there are critical links we need to public health. We need to be able to have our public health officials in the communities testing people for HIV and AIDS. The ideal is to get people identified that are infected with HIV. Get them into treatment and into care. The biggest problem we face in this country today are what we call late “testers”. People who become aware of their HIV status well after they’ve been infected for four, five, six, up to eight years. In that case, they’re pretty close to becoming quite sick, actually coming down with frank AIDS and there’s a need to get them tested earlier for two reasons. The earlier you’re tested, the better the antiretroviral drugs will work, and second the less chance you have of actually spreading HIV or becoming a transmitter.

Public Health officials can make the treatment guidelines available to researchers, to physicians and people who are infected with HIV, so that people can understand how best to use the antiretroviral drugs that are available to optimize their treatment and care. On the prevention side, public health officials can also promote testing. HIV testing is a critical tool that will help bring this epidemic under control. Only through identifying those that are HIV-positive can we really help them get into treatment. Additionally, testing will help us identify HIV-negative people who are at risk for HIV infection and it will allow public health officials to counsel these individuals so that they can mitigate their behavior and stay HIV-negative.

Q: In May we recognize HIV Vaccine Awareness Day. What happens on that day and why is it important?

Dr. Carl Dieffenbach: HIV Vaccine Awareness Day is a very important day in terms of research and research activities. It is a day when HIV Vaccine researchers thank the people who have participated in vaccine trials. Additionally, it’s that time set aside to have frank conversations with the communities about what it means to participate in vaccine trials and why we need an HIV vaccine. The way out of this epidemic, this global pandemic of HIV, is through prevention research and then implementation of prevention tools. A vaccine remains our greatest hope as a prevention tool; however, we need research first to help us identify such a tool.

Moving forward the communities that need to participate in a HIV vaccine trial need to understand what participation means, the risks associated with participation, as well as understanding the origin of HIV and how HIV is transmitted. HIV remains primarily a sexually transmitted disease. You do not catch HIV from receiving an HIV vaccine. These are the important messages that we need to get out on HIV Vaccine Awareness Day.

Q: Thank you for speaking with us today about the important work that NIAID is doing to help people living with or at risk for HIV/AIDS. For more information on NIAD go to

Please visit to view the transcript of this podcast. This podcast was created in partnership with the US Department of Health and Human Services, Office of HIV/AIDS Policy, the managing entity of

Last revised: 06/19/2008