By Leo Smith
IT WAS A VERY DIFFERENT TIME FOR WOMEN WHEN Yvonne J. Bryson, MD, entered medical school at the University of Texas more than 50 years ago. She was one of just 13 women in her class of more than 100 students at UT Southwestern in the mid- 1960s — an “experiment” by the medical school, she calls it.
The campus environment for her and her female classmates was none too welcoming. “I didn’t know that women were not supposed to go into medicine and science,” she says. “We were told that we were taking up another space that should have been for a male.” This attitude only intensified her determination. “We just wanted to be doctors, so we did not pay attention,” she says. “I guess I never take ‘no’ for an answer.”
It is a trait that has served her well through the course of her long career as a pediatric infectiousdiseases specialist and one of the world’s leading researchers and clinicians in the ongoing fight against HIV/AIDS.
Dr. Bryson credits her tenacity to her upbringing. She grew up in a family that emigrated from Dublin, Ireland, and her mother and father were keen to teach their children the importance of self-reliance. “My sisters and I were taught that despite being female, we could aspire to do anything,” she says.
That inspired “an incredible curiosity to seek answers and solutions when faced with new challenges.” But it was not science or medicine that first drew her attention. “From childhood, I loved ballet,” Dr. Bryson says. “I wanted to be a prima ballerina.” She did choreography and danced in summer musicals and opera performances in Dallas and was offered a scholarship to the prestigious Julliard School in New York City. But her parents thought she was too young, and they persuaded her to put it off until after college “if that was still my dream.”
At university, she studied teaching and biology, and she also taught dance. Though she ultimately did not pursue her earlier ambition, it helped to build the foundation for her future career and successes. “The passion and dedication you learn from dance apply in medicine as well,” she says. When she entered medical school at UT, she was immediately drawn to infectious diseases.
Dr. Bryson earned her MD in 1970, and after completing her residency and fellowship training, joined the faculty of UCLA, where the focus of her work became viral infections and, specifically, perinatal transmission of infections from mother to child. Her early reputation was built on her work to treat and prevent mother-to-child transmission of herpes simplex virus. “It can cause devastating disease in the newborn, but it is something that can be prevented if we know the status of the mother,” Dr. Bryson says.
Then came the early-80s and AIDS. “Yvonne was an expert in herpes virus, and we had early suspicions that AIDS was a viral illness,” recalls Michael Gottlieb, MD, a UCLA immunologist who, in 1981, was the first physician to describe the syndrome that would become known as AIDS. “He wanted to know if I thought it was a virus,” Dr. Bryson recalls. “I said yes, it could be a virus, but it was like no virus I had ever seen before.” She and Dr. Gottlieb became close colleagues, and “her words of encouragement helped me keep going” through a number of difficult periods, Dr. Gottlieb recalls.
It was not long before Dr. Bryson started to see newborns and young children infected with HIV coming to UCLA and other Los Angeles hospitals. “I saw infants and mothers dying. That is something that you must investigate. It took an emotional toll on all of us,” she says. “I wanted to know what we could do about it. Why did one mother transmit the infection and another mother didn’t?” Her determination to find answers when faced with new challenges drove Dr. Bryson to dig deeper.
“We needed screening for mothers with HIV antibodies to see who was at risk, treatment of mothers during gestation and delivery and prophylaxis to the infant.” It was an enormous undertaking, but she eventually became a significant voice influencing the Centers for Disease Control and Prevention to recommend use of the antiviral drug azidothymidine — what became known as AZT — to reduce perinatal transmission of HIV. Before that, one-in-four babies born to HIV-infected mothers were infected. Now, she says, the rate of maternal transmission is less than 1.5%. In 2014, Dr. Bryson made headlines when she and a colleague in Long Beach treated an HIV-positive baby with a course of antiretroviral drugs, and six days later the virus could no longer be detected.
“It’s the earliest I’ve ever seen the virus disappear,” Dr. Bryson said in a television interview after. “It means with early treatment we might be able to nip the virus in the bud.” Today, Dr. Bryson continues her work to eliminate pediatric AIDS and develop new therapies to bring about remission and cure for HIV. And she co-chairs a National Institutes of Health multicountry study to treat high-risk babies early, before they are identified as infected. “We’ve made great strides,” Dr. Bryson says. “I have the joy of seeing children who were very sick now grow up to have children of their own, free of the infection. It is wonderful to have lived long enough to maybe someday see myself become redundant.”
Leo Smith is managing editor for UCLA Health Communications.