Why it’s so hard to cure HIV/AIDS - Janet Iwasa

Zašto se HIV/AIDS tako teško leči - Dženet Ivasa (Janet Iwasa)

Prevodilac: Ljiljana Colic Lektor: Mile Živković

In 2008, something incredible happened: a man was cured of HIV.

U 2008. godini se desilo nešto neverovatno: čovek je izlečen od HIVa.

In over 70 million HIV cases, that was a first and, so far, a last.

U preko 70 miliona slučajeva HIVa, ovo se desilo prvi, i, do sad, zadnji put.

We don't yet understand exactly how he was cured.

I dalje ne razumemo kako je on tačno izlečen.

We can cure people of various diseases, such as malaria and hepatitis C,

Možemo da izlečimo ljude od različitih bolesti poput malarije i hepatitisa C,

so why can't we cure HIV?

pa zašto onda ne možemo da izlečimo HIV?

Well, first let's examine how HIV infects people

Pa, hajde prvo da ispitamo kako se ljudi zaraze HIVom

and progresses into AIDS.

i kako on napreduje u AIDS.

HIV spreads through exchanges of bodily fluids.

HIV se širi preko razmene telesnih tečnosti.

Unprotected sex and contaminated needles are the leading cause of transmission.

Nezaštićen seks i zaražene igle su glavni uzročnici prenošenja.

It, fortunately, cannot spread through air, water, or casual contact.

Na sreću, ne može da se širi putem vazduha, vode, ili slučajnim dodirom.

Individuals of any age, sexual orientation, gender and race

Pojedinci svih starosti, seksualne orijentacije, pola ili rase

can contract HIV.

se mogu zaraziti HIVom.

Once inside the body, HIV infects cells that are part of the immune system.

Kada uđe u telo, HIV inficira ćelije koje su deo imunog sistema.

It particularly targets helper T cells,

Posebne mete su mu T pomoćne ćelije,

which help defend the body against bacterial and fungal infections.

koje pomažu telu da se brani od bakterijskih i gljivičnih infekcija.

HIV is a retrovirus,

HIV je retrovirus,

which means it can write its genetic code into the genome of infected cells,

što znači da može da upiše svoj genetički kod u genom zaraženih ćelija,

co-opting them into making more copies of itself.

navodeći ih da prave svoje kopije.

During the first stage of HIV infection,

Tokom prvih faza infekcije HIVom,

the virus replicates within helper T cells,

virus se množi unutar T pomoćnih ćelija,

destroying many of them in the process.

uništavajući ih tokom tog procesa.

During this stage, patients often experience flu-like symptoms,

Tokom ove faze, pacijenti često osećaju simptome slične prehladi,

but are typically not yet in mortal danger.

ali obično još nisu u smrtnoj opasnosti.

However, for a period ranging from a few months to several years,

Međutim, tokom perioda od nekoliko meseci do nekoliko godina,

during which time the patient may look and feel completely healthy,

pacijent može izgledati i može se osećati potpuno zdravo,

the virus continues to replicate and destroy T cells.

dok se za to vreme virus množi i uništava T ćelije.

When T cell counts drop too low,

Kada se broj T ćelija drastično smanji,

patients are in serious danger of contracting deadly infections

pacijenti se nađu u ozbiljnoj opasnosti da se zaraze smrtnim infekcijama

that healthy immune systems can normally handle.

s kojima se zdrav imuni sistem inače može izboriti.

This stage of HIV infection is known as AIDS.

Ova faza zaraze HIVom je poznata kao AIDS.

The good news is there are drugs that are highly effective

Dobra vest je da postoje lekovi koji su veoma efikasni

at managing levels of HIV

u kontrolisanju nivoa HIVa

and preventing T cell counts from getting low enough

i u sprečavanju da se broj T ćelija toliko smanji

for the disease to progress to AIDS.

da bolest uznapreduje u AIDS.

With antiretroviral therapy,

Sa antiretrovirusnom terapijom,

most HIV-positive people can expect to live long and healthy lives,

mnogi HIV pozitivni ljudi se mogu nadati dugim i zdravim životima,

and are much less likely to infect others.

i mala je verovatnoća da će zaraziti druge.

However, there are two major catches.

Međutim, postoje dve velike zamke.

One is that HIV-positive patients must keep taking their drugs

Jedna je da HIV pozitivni pacijenti moraju nastaviti da uzimaju lekove

for the rest of their lives.

do kraja života.

Without them, the virus can make a deadly comeback.

Bez njih, virus može da se vrati sa smrtnim posledicama.

So, how do these drugs work?

Dakle, kako ovi lekovi deluju?

The most commonly prescribed ones prevent the viral genome from being copied

Lekovi koji se obično propisuju sprečavaju kopiranje virusnog genoma

and incorporated into a host cell's DNA.

i njegovo pripajanje u DNK domaćinove ćelije.

Other drugs prevent the virus from maturing or assembling,

Drugi lekovi sprečavaju da virus sazre ili se obrazuje,

causing HIV to be unable to infect new cells in the body.

onesposobljavajući HIV da inficira nove ćelije u telu.

But HIV hides out somewhere our current drugs cannot reach it:

Ali HIV se krije negde gde naši današnji lekovi ne mogu da dosegnu:

inside the DNA of healthy T cells.

unutar DNK zdravih T ćelija.

Most T cells die shortly after being infected with HIV.

Većina T ćelija umire ubrzo nakon što bude zaražena HIVom.

But in a tiny percentage,

Ali u jako malom procentu,

the instructions for building more HIV viruses lies dormant,

uputstva za razvoj još više virusa HIVa su skrivena,

sometimes for years.

ponekad godinama.

So even if we could wipe out every HIV virus from an infected person's body,

Tako da kad bi i mogli uništiti sve i jedan virus HIVa u telu zaražene osobe,

one of those T cells could activate and start spreading the virus again.

jedna od onih T ćelija bi se mogla aktivirati i početi da ponovo širi virus.

The other major catch is that not everyone in the world has access to the therapies

Druga velika zamka je da nemaju svi ljudi na svetu pristup terapijama

that could save their lives.

koje bi im mogle spasiti živote.

In Sub-Saharan Africa, which accounts for over 70% of HIV patients worldwide,

U Podsaharskoj Africi, koja ima preko 70% HIV pacijenata u odnosu na celi svet,

antiretrovirals reached only about one in three HIV-positive patients in 2012.

antiretroviruse terapije su bile dostupne samo jednom od tri HIV pozitivna pacijenta

There is no easy answer to this problem.

u 2012. godini. Ne postoji jednostavan odgovor na ovaj problem.

A mix of political, economic and cultural barriers

Mešavina političkih, ekonomskih i kulturnih prepreka

makes effective prevention and treatment difficult.

otežava efikasno sprečavanje i lečenje.

And even in the U.S., HIV still claims more than 10,000 lives per year.

Čak i u Sjedinjenim državama, HIV i dalje odnosi preko 10 000 života godišnje.

However, there is ample cause for hope.

Međutim, postoji veliki razlog za nadu.

Researchers may be closer than ever to developing a true cure.

Istraživači su možda jako blizu pronalaženja istinskog leka.

One research approach involves

Jedan pristup istraživanju podrazumeva

using a drug to activate all cells harboring the HIV genetic information.

korišćenje leka koji aktivira sve ćelije koje nose genetsku informaciju HIVa.

This would both destroy those cells and flush the virus out into the open,

To bi i uništilo te ćelije i isteralo virus napolje,

where our current drugs are effective.

gde su naši sadašnji lekovi efikasni.

Another is looking to use genetic tools

Drugi pristup koristi genetički alat

to cut the HIV DNA out of cells genomes altogether.

kojim se potpuno iseče DNK HIVa iz genoma ćelije.

And while one cure out of 70 million cases may seem like terrible odds,

Iako možda jedan lek u 70 miliona slučajeva predstavlja užasne izglede,

one is immeasurably better than zero.

jedan je nemerljivo bolji od nule.

We now know that a cure is possible,

Sada znamo da je moguće doći do leka,

and that may give us what we need to beat HIV for good.

i to nam može ponuditi ono što nam treba da jednom zauvek pobedimo HIV.