Julio S. González Montaner (born April 13, 1956) is an Argentine-Canadian physician, professor and researcher. He is the director of the British Columbia Centre for Excellence in HIV/AIDS, the chair in AIDS Research and head of the Division of AIDS in the Faculty of Medicine at the University of British Columbia and the past-president of the International AIDS Society. He is also the director of the John Ruedy Immunodeficiency Clinic, and the Physician Program Director for HIV/AIDS PHC. He is known for his work on HAART (Highly Active Antiretroviral Therapy), a role in the discovery of triple therapy as an effective treatment for HIV in the late 1990s, and a role in advocating the "Treatment as Prevention" Strategy in the mid-2000s, led by Myron Cohen of the HPTN 052 trial.
Early life and career Montaner was born in Buenos Aires, Argentina in 1956, the son of Julio González Montaner, a pulmonary specialist. His father initially doubted that Montaner would follow in his footsteps, but after entering medical school, he developed a passion for medicine. He received an M.D. with Honours from the University of Buenos Aires in Argentina in 1979. Montaner originally planned on following his father's career in pulmonary medicine, and accepted an invitation to do a one-year post-doctoral fellowship at the University of British Columbia in 1981 in the Pulmonary Research Laboratory, which was directed at the time by James C. Hogg. His initial research focused on animal models of acute lung injury. Montaner initially planned on returning to Argentina after completing his fellowship. After meeting his future wife at St. Paul's Hospital in the early 1980s, he decided to remain in Canada. He completed his residency at the University of British Columbia in the Department of Internal Medicine and Respiratory Medicine and was appointed Chief Resident for the Department of Medicine from 1986 to 1987. Montaner then joined the faculty at St. Paul's Hospital/University of British Columbia in Vancouver, British Columbia, in 1987. John Ruedy, at the time the head of the Department of Medicine at St. Paul's Hospital, invited him to run the new HIV department that was being established in response to the emerging AIDS crisis. Ruedy appointed him as the director of the AIDS Research Program and the Infectious Disease Clinic in 1989. Montaner's shift to HIV research began when he encountered AIDS patients with Pneumocystis carinii pneumonia while completing his training in pulmonary medicine. He encountered the opportunity to test AZT monotherapy for HIV as part of his work on PCP, which sparked an interest in HIV research. Montaner was the only member of the HIV department at St. Paul's Hospital when it was first founded. He became the founding co-director of the Canadian HIV Trials Network in 1990 with Martin Schechter. In 1992, he was joined by Michael O’Shaughnessy to found the B.C. Centre for Excellence in HIV/AIDS in 1992. Montaner was appointed a National Health Research Scholar of Canada (NHRDP) from 1988 to 1998. In 1996, Montaner presented the results of his pioneering research on triple therapy to treat HIV infections at the XI International AIDS Conference in Vancouver, creating new standard for HIV drug therapy. In 1997, he was appointed a Professor of Medicine at the University of British Columbia. Montaner served as the president of the International AIDS Society from 2008 to 2010, and as of 2013, continues to serve as an elected member of the Council of the International AIDS Society after his term as president ended. As of 2013, he also serves as the director of clinical activities at the BC Centre of Excellence in HIV/AIDS, a professor of medicine at UBC, physician program director for HIV/AIDS PHC and continues to serve as the director of the John Ruedy Immunodeficiency Clinic at St. Paul's Hospital. Montaner is the editor of the B.C. Centre Therapeutic Guidelines and oversees its Drug Distribution Program. In 2002, he was awarded the $1 million Distinguished Researcher Award in HIV.1 He was awarded the Avant-Garde Award of $2.5 million over 5 years, from the National Institute on Drug Abuse of the National Institutes of Health, in support of the "Seek and Treat for Optimal Outcomes and Prevention in HIV & AIDS in IDU (STOP HIV/AIDS)" strategy of treatment as prevention in 2010.
Research
Respiratory medicine research As a post-doctoral fellow and resident, Montaner's research was initially focused on respiratory medicine. He participated in and led a series of studies on the role of adjunctive corticosteroids in treating Pneumocystis carinii pneumonia (PCP) patients. PCP is an opportunistic infection commonly found in AIDS-stage HIV positive patients and was one of the major killers of HIV-positive patients at that time. Montaner and his colleagues found that oral corticosteroid treatment administered early to AIDS patients experiencing their first moderate to severe P. carinii pneumonia episode prevented early deterioration and improved oxygen saturation, a key indicator of survival in PCP patients. Montaner and the study's co-authors found that only 5.6% of the patients given Prednisone (a corticosteroid) reached the study-end point of a 10% decrease in oxygen saturation compared to 42.1% of the patients on the placebo drug. The Prednisone group also demonstrated increased long-term exercise tolerance, another indicator of long-term survival. As a result of this study, Montaner was one of the first doctors to implement the strategy of treating PCP patients with steroids. The approach of treating immunosuppressed patients with steroids, which are anti-inflammatory drugs, was unorthodox at the time but Montaner pursued this strategy as he "believed [HIV] was a matter of immune dysregulation as much as suppression.". Montaner and his colleagues published their findings in Chest in 1989 and the Annals of Internal Medicine in 1990. Montaner's research and similar findings from other pulmonary researchers at the time led to the release of a consensus statement from a NIH-University of California Expert Panel recommending the treatment of HIV-positive PCP patients with corticosteroids.
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