HIV/AIDS researcher David Katzenstein dies

The Stanford virologist conducted clinical vaccine trials, which led to the approval of antiretroviral drugs, greatly improving the survival of people living with HIV

- By Bruce Goldman

David Katzenstein was widely praised for his efforts to bring better, cheaper methodologies to bear on HIV/AIDS prevention and treatment in Africa.

David Katzenstein, MD, professor emeritus of infectious diseases and global health at Stanford Medicine, who spurred advances in diagnosing, treating and preventing AIDS, died Jan. 25 of COVID-19 in Harare, Zimbabwe. He was 69.

Katzenstein was a trained virologist, clinician and tireless advocate for global health. He was widely praised for his energetic push to bring better, cheaper methodologies to bear on HIV/AIDS prevention and treatment in middle- and low-income African countries, where over a 35-year period he spearheaded numerous life-saving projects.

“Imbued with a passionate belief in social justice, David Katzenstein had an outsized impact on the fight against HIV in sub-Saharan Africa,” said Lloyd Minor, MD, dean of the School of Medicine. “The Stanford Medicine community is grieving his untimely passing. We will miss him immensely.”

Colleagues described him as a renowned laboratory scientist, brilliant thinker, stellar mentor and overall optimist.

“It’s hard to visualize David’s face without a smile on it,” said Julie Parsonnet, MD, professor of infectious diseases and of epidemiology and population health. Parsonnet, the George DeForest Barnett Professor in Medicine, arrived at Stanford in 1989, as did Katzenstein, and worked closely with him on a number of projects dedicated to reducing HIV transmission in Zimbabwe.

“He was creative, electric,” Parsonnet said. “Ideas would just come shooting out of his head so fast you couldn’t keep up with him.”

As longtime associate director of Stanford’s AIDS Clinical Trial Group, Katzenstein oversaw influential clinical trials of AIDS antiviral therapeutics. He was one of the first researchers to call attention to the problem of antiviral drug resistance in Africa.

“He introduced me to Zimbabwe,” said Bonnie Maldonado, MD, the Taube Professor of Global Health and Infectious Diseases and professor of pediatric infectious diseases and of epidemiology and population health at Stanford. “We’d travel there together, or meet up there. After accomplishing so much by way of improving HIV treatment in the United States, he wanted to rid the world of HIV. He was brilliant in the laboratory and wonderful with people.” 

Katzenstein trained dozens of young researchers throughout the world, said Robert Shafer, MD, professor of infectious diseases at Stanford. “David was my first mentor when I arrived here as a postdoc in 1990,” Shafer said. “For six months I met with him every day for an hour going over published papers.” 

Native of Connecticut

Born Jan. 3, 1952, in Hartford, Connecticut, Katzenstein earned a bachelor’s degree in biology in 1973 and a medical degree in 1977, both from the University of California-San Diego. He interned in internal medicine at the University of New Mexico, where his work with indigenous tribes instilled in him a deep desire to combat infectious disease among underserved populations. 

He completed his residency in internal medicine at UCSD in 1980, along with a fellowship in infectious diseases there in 1981. In 1982, he was appointed assistant clinical professor of infectious diseases at the University of California-Davis, and in 1984 he accepted an assistant professorship of infectious disease at the University of Minnesota.

In 1986, he departed for Africa, where he served as a lecturer at the University of Zimbabwe’s Godfrey Huggins School of Medicine.

Between 1987 and 1989, Katzenstein worked under Anthony Fauci, MD, now chief of the National Institute of Allergy and Infectious Diseases, as a senior research fellow at the Food and Drug Administration’s Laboratory of Retrovirus Research Center for Biologics Evaluation and Research. 

Katzenstein began his tenure at Stanford in 1989 as a clinical assistant professor of infectious diseases, as well as the associate medical director of Stanford’s AIDS Clinical Trial Group. With his colleagues, he conducted multiple studies, ultimately leading to the approval of life-saving antiretroviral drugs that greatly improved the survival of people living with HIV. From that point on, the problem of HIV drug resistance occupied a significant portion of his academic endeavors.

“David’s major strength was in his scientific imagination and his sharing of it with friends and colleagues,” said Thomas Merigan, MD, the George E. and Lucy Becker Professor of Medicine, emeritus, who as then-chief of the Department of Medicine’s infectious diseases division recruited Katzenstein to Stanford. “He did this in a wonderful, warm manner, which made him a great mentor, friend and leader of our group.” 

Life-changing hiking accident

In a hiking accident in Big Sur in 2009, Katzenstein plunged 90 feet into a ravine, sustaining a compound leg fracture that required 17 separate surgeries. The bone became infected and never fully healed. Initially wheelchair-bound, he walked with a cane for the rest of his life.

Undaunted, he resumed his work with characteristic zeal. His desire to cure and prevent infectious disease in developing countries grew.

“With the success of long-term antiviral drug treatment, AIDS was now relatively well under control in the United States,” Parsonnet said. “But those drugs were expensive. David was driven to find ways of bringing their benefits to less-affluent populations — and he missed Zimbabwe.”

 Katzenstein moved to Zimbabwe immediately upon retiring from Stanford in 2016. As director of the Biomedical Research Training Institute in Harari, he introduced state-of-the-art molecular diagnostics and disease monitoring to Zimbabwe’s community-based treatment programs and trained people in clinical research. He remained extremely active and continued publishing papers until he fell ill with COVID-19.

Katzenstein co-authored nearly 300 peer-reviewed papers and patents awarded to Stanford for the use of the molecular technique called polymer chain reaction, or PCR, in identifying HIV resistance variants, determining the choice of AIDS therapies and monitoring patients’ response to anti-retroviral drug combinations.

He served on the editorial board of the journal Current HIV Research and was an active member of the American Society for Microbiology, the Infectious Disease Society of America, the Society for General Microbiology, the International AIDS Society, the American Federation for Clinical Research and the Southern Africa Treat Research Network. 

In 2000, the Doris Duke Charitable Trust awarded him its Distinguished Clinical Scientist Award, a five-year grant underwriting his efforts to foster affordable treatments for HIV-infected women in southern Africa.

Katzenstein was preceded in death by his wife, Sharon Mayes, who died in 2007. He is survived by his siblings, Rob Katzenstein of Grass Valley, California; Ruth Souza of Los Angeles, California; and Amy Harrington of Santa Cruz, California. He is also survived by his step-daughter, Melissa Sanders-Self of Santa Cruz and her sons, Dylan and Luke. 

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