San Francisco Chronicle - August 9, 2006
Carl Hall, chall@sfchronicle.com.

Abrams, 56, is leaving his HIV practice to begin a new role as head of a complementary medicine program at UCSF, where the focus is on alternative treatments for cancer. He and colleagues, led by Dr. Paul Volberding, founded the pioneering San Francisco General HIV clinic, one of the first outpatient programs in the country to take on the AIDS epidemic.

Abrams also is stepping down from the helm of a Bay Area clinical research network of about 200 local HIV/AIDS practitioners, known as the Community Consortium.

He spent Tuesday afternoon in his last seven HIV clinic appointments, saying goodbye to patients he has been treating for years, including one person Abrams has been seeing for nearly two decades.

The stability of the caseload, due mostly to the advent of effective antiviral drugs, marks a big change from the epidemic's early days when doctors had little to offer besides palliative care and lots of hand-holding.

"I'm very happy for my patients now," Abrams said. "HIV has become so much more of a chronic manageable disease. It used to be just one person dying after another."

The payoff in life expectancy brought a new set of challenges, which led innovators in the AIDS clinics toward some new medical frontiers. Abrams, for instance, gained notoriety for his recent studies of medical marijuana, used by some AIDS patients to control nerve pain.

But he said his long tenure, along with the transformation of HIV care, also led him to seek other projects.

"Doing anything for 23 years is a long time," he said. "In the beginning, we had the urgency of the problem, the mystery of the disease, and it was all very exciting and stimulating. That sparkle became a little diminished for me."

In 2004, he completed a fellowship at the University of Arizona Program in Integrative Medicine, directed by Dr. Andrew Weil. Abrams said he decided he was ready to switch full-time to the alternative medicine field when he returned to UCSF.

He now becomes director of clinical programs at the Osher Center of Integrative Medicine, replacing Dr. Sylver Quevedo, who left UCSF to head the integrative medicine department at Duke University. Abrams will continue to serve as head of the hematology/oncology division at General, but no longer will take care of people with HIV unless they also need cancer care.

Colleagues said it was a logical change, noting Abrams' long interest in expanding the medical armamentarium.

"It's a great career move for him," Volberding said. "This has been a passion of his for many years."

Abrams now gets to conduct investigations and advise patients on such matters as the healing powers of spirituality -- one of many alternative-medicine topics still capable of raising eyebrows along with hopes. Abrams said the move away from the HIV clinic was not a tough choice.

"It's a natural evolution of my career," he said.

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