How close are we to eradicating HIV? - Philip A. Chan

Prevoditelj: Senzos Osijek Recezent: Sanda L

The world is getting closer

Svijet se bliži

to achieving one of the most important public health goals of our time:

ostvarenju jednog od najbitnijih ciljeva javnog zdravstva:

eradicating HIV.

iskorjenjivanju HIV-a.

And to do this, we won’t even have to cure the disease.

Da bismo ovo postigli, ne moramo čak ni izliječiti bolest.

We simply have to stop HIV from being transmitted

Jednostavno moramo zaustaviti prijenos HIV-a s osobe na osobu,

until eventually it fizzles out.

dok jednog dana ne nestane.

Once, this goal would have seemed impossible.

Taj cilj se prije činio nemogućim.

HIV has caused millions of deaths

HIV je odnio milijune života

and is one of the most devastating diseases that humanity has ever known.

i jedna je od najgorih bolesti s kojom se čovječanstvo susrelo.

But we’re now at a point where new advances

Sada smo došli do trenutka kada napredak

such as one-pill, once-a-day medications

poput jedne tablete, tablete koju uzimate jednom dnevno,

are helping us tackle HIV in effective ways.

pomaže da se učinkovito borimo s HIV-om.

HIV is a retrovirus–

HIV je retrovirus,

meaning it integrates copies of itself into an infected cell’s DNA,

što znači da ugrađuje svoje kopije u DNA zaražene osobe

allowing it to replicate and infect other cells.

te se tako množi i zarazi okolne stanice.

HIV has evolved numerous ways to evade the human immune system,

HIV je razvio brojne načine kako izbjeći imunosni sustav čovjeka,

which makes it difficult to cure.

što ga čini teškim za liječenje.

But by developing ways to block HIV replication,

Ali razvijajući metode kako zaustaviti razmnožavanje HIV-a,

we can stop the spread of HIV itself.

možemo zaustaviti širenje HIV-a.

That’s where antiretrovirals– a.k.a. ARVs– come in.

Antiretrovirusni, tzv. ARV pomažu.

ARVs are a group of drugs which work in different ways to combat HIV.

ARV su grupa lijekova koji na različite načine djeluju na HIV.

Some block HIV’s access into immune cells,

Neki blokiraju ulazak HIV-a u imunosne stanice,

and others work by stopping the virus itself from replicating.

dok drugi rade zaustavljajući razmnožavanje virusa.

ARVs also work preventatively in people who don’t have HIV.

ARV-i također djeluju preventivno kod ljudi koji nemaju HIV.

This type of approach is called pre-exposure prophylaxis, or PrEP.

Takav način davanja se zove preekspozicijska profilaksa ili PrEP.

PrEP works by accumulating in a person’s body

PrEP djeluje tako da se nakuplja u tijelu osobe

and preventing HIV from establishing itself.

i sprječava napredak HIV-a.

That means an HIV-negative person who may be at risk of contracting the disease

To znači da HIV negativne osobe koje su u riziku od oboljenja

can take certain ARVs to protect themselves,

mogu koristiti ARV kako bi se zaštitile

before they become exposed.

prije nego se izlože virusu.

Here’s where it gets especially interesting:

Ovo je zanimljivo:

In people with HIV, ARVs can also dramatically reduce HIV transmission.

ARV drastično smanjuju prijenos HIV-a kod osoba koje su zaražene HIV-om.

This is called “Treatment as Prevention.”

Ovo se zove "Liječenje kao prevencija."

On a global scale, this has the potential to end the HIV epidemic.

Na globalnoj razini, ima potencijal zaustaviti HIV epidemiju.

It’s based on the idea that someone with HIV who takes ARV’s

Ideja je da osobe s HIV-om koje uzimaju ARV

can lower the virus level in their bodies until it becomes undetectable.

mogu smanjiti razinu virusa u svome tijelu do granice nemjerljivosti.

That doesn’t mean the virus is gone;

To ne znači da je virus nestao,

it could still be lurking within cells, ready to reactivate if treatment stops.

i dalje je možda u stanicama, čeka reaktivaciju ako liječenje prestane.

But so long as it’s kept dormant with drugs,

Ali dok je god pritajen zbog lijeka,

HIV remains undetectable.

HIV je nemjerljiv.

And when HIV is undetectable, it’s untransmittable, too.

A kad je HIV nemjerljiv, onda je i neprenosiv.

In theory this means that by testing everyone who’s at risk of HIV

U teoriji, to znači ako se sve osobe koje su rizične za HIV testiraju

and treating those who test positive,

te se tretiraju one koje su pozitivne,

we could stop transmission and eventually eradicate HIV.

mogli bismo zaustaviti prijenos i s vremenom iskorijeniti HIV.

In the real world, however, things are more complex.

U stvarnom svijetu stvari su složenije.

Many at-risk HIV negative people across the world

Mnoge rizične HIV negativne osobe diljem svijeta

do not have access to PrEP or ARVs,

nemaju pristup PrEP-u ili ARV-u,

and those who are HIV positive may experience challenges to taking ARVs.

i oni koji su HIV pozitivni možda ne mogu uzimati ARV.

These problems are often greatest in countries

Ti problemi su često izraženi

u državama gdje je pojavnost HIV-a najveća.

where the burden of HIV is highest.

Getting these medications depends on access to a functioning healthcare system–

Dostupnost lijekova ovisi o funkcionalnosti zdravstvenog sustava,

and this isn’t something everyone has.

što često nemaju svi dostupno.

That’s part of the reason why stopping the spread of HIV for good

To je djelomično razlog zašto će za trajno sprečavanje širenja HIV-a

will require a significant investment of resources to improve those systems.

biti potrebno uložiti u te sustave.

One study carried out by the UNAIDS

Jedno istraživanje UNAIDS-a

estimated that between 20-30 billion dollars per year

pretpostavlja da bi trebalo oko 20 do 30 milijardi dolara na godinu

would be needed to achieve a nearly 90% reduction

kako bi broj novih HIV infekcija do 2030. godine

in new HIV infections by 2030.

pao za 90 posto.

This investment would ensure more people would get tested in the first place,

Ulaganje bi osiguralo da se više ljudi zapravo testira

and more would be able to access and maintain treatment.

i više njih bi imalo pristup terapiji.

Achieving this goal and improving healthcare in general

Postizanje ovog cilja i unapređenje zdravstvenog sustava općenito

is in everyone’s best interest,

je bitno svima,

from individual people to society as a whole.

od pojedinaca do cjelokupnog društva.

We have roadmaps that could allow us

Imamo planove koji bi doveli

to bring the HIV epidemic to an end in the near future,

do završetka epidemije HIV-a u bliskoj budućnosti,

with the possibility of eradicating the disease altogether

s mogućnošću iskorjenjivanja bolesti

several generations in the future.

u svega nekoliko generacija.

In the period from 1996 to 2017

U razdoblju od 1996. do 2017. godine

we almost halved the number of new HIV infections,

gotovo smo prepolovili broj novih HIV infekcija,

and for the millions of people who still live with the virus,

i za milijune ljudi koji žive s virusom,

ARV treatments enable most to lead long and healthy lives.

ARV terapija im omogućuje dugačak i zdrav život.

With continued and increased investments,

Daljnjim i povećanim ulaganjima

we can get transmission rates low enough to end HIV once and for all.

mogli bismo smanjiti stope prijenosa i time zaustaviti HIV zauvijek.

A world without HIV is no longer inconceivable:

Svijet bez HIV-a više nije nezamisliv,

it’s closer than ever.

bliži je nego ikad.