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诺贝尔医学奖得主：攻克艾滋病还要多久
来源：新华网 2011年06月06日17:10
【美国《纽约时报》6月4日文章】题：寻找HIV治疗方法(作者巴黎巴斯德研究所抗逆转录病毒感染监控处主任、国际艾滋病协会当选主席、诺贝尔医学奖获得者弗朗索瓦丝·巴雷-塞努西)
5日是首批艾滋病病例出现30周年纪念日。自那时起，对艾滋病病毒(HIV)的科学研究带来了预防与治疗方面的突破，其中最了不起的就是抗逆转录病毒疗法，它确保了数百万HIV携带者过上健康的生活。
此外，现在有确凿证据表明，及早并积极地采用抗逆转录病毒疗法有助于大大减少HIV的传播，证明了“治疗即是预防”理念。
艾滋病不再像过去那样等同于死刑，但获得治疗的长期可持续性尤其是在资源有限的环境中仍极不确定。
我们比以往任何时候都更需要找到一种HIV治疗方法。我们需要投资开展研究，找到更好、更划算的治疗策略，那也许至少会带来一种实用的治疗办法在治疗中断以后非常有效并持续地控制HIV，从而长期减轻患者的痛苦。
为何HIV如此顽固
人们不禁要问：对HIV的研究已进行了30年，为什么我们仍未找到治疗办法？
答案在于，HIV和宿主之间的互相影响错综复杂，接受抗逆转录病毒治疗的人体内HIV十分顽固，我们对感染最早期的情况知之甚少，这一切造成诸多障碍。不过，有令人鼓舞的迹象表明，HIV发病机理拼图的碎片开始各就各位。
我们早就知道，藏匿HIV病毒的HIV潜伏池是找到治疗办法的主要障碍之一。治疗无法根除HIV、治疗停止以后病毒会再度肆虐的原因就在于此。
但直到最近，我们才有了科学进步和新的方法来对付这些病毒池。例如，关于HIV在潜伏池中的存留原理，我们的了解远远超过了10年前。我们还看到，近来的研究和小规模再活化剂试验令人鼓舞，再活化剂可以扭转潜伏性并“冲洗”HIV池。
我们还一直明白，所谓的“精英患者”感染HIV至少10年、不接受治疗却并未患上艾滋病的极少数人始终是未来疗法研究的一个重要组成部分。
现在我们对这个特殊的患者群体有了更深入的了解。最近有研究显示，精英控制者状态与宿主的基因有关，基因使之具有强大的免疫力和/或保护其CD4淋巴细胞和巨噬细胞免受感染。
我们相信，了解这个有效控制着病毒复制与储存的人群将是我们设法获得一种“实用的”治疗办法以便长期减轻受感染者之痛苦的关键。
近期可能取得突破
上周有消息称研究人员发现了免疫细胞中有一个新的制约因素可抑制HIV-Ⅰ型生命周期的最早期，这同样令人振奋。关于天生的HIV控制力的最新发现对于艾滋病的治疗具有深远意义，有助于我们开发治疗性疫苗。
另外，治疗办法现在有了科学家们常说的“概念验证”。柏林的患者蒂莫西·布朗在2007年接受了干细胞骨髓移植以缓解白血病，如今据认为，他的艾滋病被治好了。这就为我们提供了一个办法。
认为这种大量用药、花费高昂、难以再现的治疗方案可以复制并推广的想法显然是不切实际的，但确实使科学界开始讨论找到治疗办法的可能性。
基因疗法的最新动向也鼓舞人心。桑加莫研究小组的保罗·坎农最近利用“基因编辑”来除去HIV赖以进入宿主细胞的CCR5受体基因，说明基因疗法很可能会是一种有效的干预，比化学疗法和干细胞移植要容易进行。
我相信，以我们现有的知识以及创新工具和概念，近期内找到一种实用的治疗办法是比较现实的目标。
找到治疗办法需要经费投入、社区参与、创新科研以及进一步的多学科协作，需要加强基础研究与临床研究之间的联系总之，需要我们赖以取得当今全球抗逆转录病毒治疗成果的一切因素。
30年时间很长，是的，我们仍然没有找到治疗办法，但科学表明我们或许应当行动起来，假如我们不认真开始寻找，难道我们想在以后的30年里后悔不曾尝试吗？来源新华国际)
艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复
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| 图示∶2011年5月正式出版的《中国特色医疗金鉴》登载的刘君主任及其机构事迹 |
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Nobel Laureate: How long to overcome AIDS
Source: Xinhua at 17:10 on June 6, 2011 I Laiyueliangju (0) copy the link to the print medium and small medium and small medium and small U.S. The "New York Times," June 4 article】 Question: Looking for HIV treatment ( of the Pasteur Institute in Paris at the anti-retroviral infection control director, was elected President of the International AIDS Society, Nobel Prize winner Francoise Barre - Se Nuxi)
5 is the first anniversary of AIDS cases was 30. Since then, the AIDS virus (HIV), bringing scientific breakthroughs in prevention and treatment, the most remarkable is the anti-retroviral therapy, it ensures that millions of HIV carriers live a healthy life.
In addition, there is now strong evidence that early and active use of anti-retroviral therapy can help significantly reduce the spread of HIV, prove that "treatment is prevention" philosophy.
AIDS is no longer the same as the death penalty as in the past, but the long-term sustainability of access to treatment, especially in resource-limited environment remains extremely uncertain.
We are more than ever need to find a treatment for HIV. We need to invest in research to find better, more cost-effective treatment strategies, it may at least bring a practical approach in the treatment interruption after the treatment is very effective and sustained control of HIV, thereby reducing long term pain patients.
Why HIV is so stubborn
People will ask: The research has been conducted on HIV for 30 years, why do we still have not found a cure?
The answer is, HIV and the interaction between the host complex antiretroviral therapy HIV human body is very stubborn, and we know very little about the case of very early infection, all caused a lot of obstacles. However, there are encouraging signs that, HIV pathogenesis puzzle pieces start coming out.
We knew, conceal latent pool of HIV virus HIV is to find a cure for one of the main obstacles. Treatment failed to eradicate HIV, treatment was stopped after the outbreak of the virus will again the reason why.
But until recently, we have the scientific advances and new ways to deal with the virus pool. For example, on the lifetime of HIV in the latent pool principles, our understanding is far more than 10 years ago. We have also seen recent studies and small-scale tests are encouraging re-activator, and then to reverse the latent activator and "flush" HIV pool.
We also have to understand, so-called "elite were" at least 10 years of HIV infection is not treated but not the very small number of people suffering from AIDS in the future therapy is always an important part of the study.
Now we have this special group of patients a better understanding. Recent studies have shown that elite controller status and host genes, gene so that it has a strong immunity and / or protection of their CD4 lymphocytes and macrophages from infection.
We believe that to understand the effective control of viral replication and storage will be our people managed to get a "practical" approach to long-term treatment of infected people to reduce the pain of the key.
Possible breakthrough in the near future
Last week, news that researchers have discovered a new immune cells in the constraints inhibit HIV-Ⅰ type the earliest life-cycle, which is also exciting. HIV on the natural control of the newly discovered treatment for AIDS has far-reaching, will help us to develop therapeutic vaccines.
In addition, the treatments often said that scientists now have the "proof of concept." Timothy West Brom in Berlin in 2007 patients received bone marrow stem cell transplantation to alleviate the leukemia, and now He is believed to be cured of AIDS. This provides us a way.
That such a large number of drugs, costly, and difficult to reproduce the treatment program can be replicated and extended the idea is clearly unrealistic, but it does the scientific community started to discuss the possibility of finding a cure.
The latest trends in gene therapy are also encouraging. Sangamo Paul Rokkan agricultural research team recently used "gene editing" to remove the HIV to enter host cells which CCR5 receptor gene, that gene therapy is likely to be an effective intervention, than chemotherapy and stem cell transplantation to easily.
I believe that with our current knowledge and innovative tools and concepts, in the near future to find a practical approach is more realistic treatment goals.
Funds needed to find a cure, community participation, innovation, multidisciplinary research and further collaboration, the need to strengthen basic research and clinical studies the link between the word, which we need to get today's global anti-retroviral therapy results in all factors.
30 years is very long, yes, we still have not found a cure, but science shows that we may be action, if we do not seriously start looking, do we want to regret after 30 years did not try it? Source Xinhua International)
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