The dangerous evolution of HIV | Edsel Salvaña

Translator: Jon Elizagaray Reviewer: Jone Aliri Lazcano

The Philippines: an idyllic country

Filipinak: herrialde amesgarria

with some of the clearest water and bluest skies on the planet.

mundu osoko ur eta zeru gardenetarikoekin.

It is also the epicenter

Baita HIESaren epidemiaren epizentro garrantzitsuenetarikoa

of one of the fastest-growing HIV epidemics in the world.

On the surface, it seems as if we are just a late bloomer.

Itxuraz, agerraldi berantiarra baino ez dela dirudi.

However, the reasons for our current epidemic

Baina epidemia honen arrazoiak

are much more complicated

askoz konplexuagoak dira

and may foreshadow a global resurgence of HIV.

eta mundu mailako agerraldi berri baten zeinu izan daitezke.

While overall new cases of HIV continue to drop in the world,

Mundu osoan kasu berrien kopurua gutxitzen ari den bitartean,

this trend may be short-lived

joera hau laburra izan daiteke

when the next wave of more aggressive and resistant viruses arrive.

agresibo eta erresistentzia handiagoko birusen olatu berri bat iristerakoan.

HIV has a potential to transform itself into a new and different virus

HIESak, zelula bat infektatzen duen bakoitzean,

bere burua beste motako birus batean transformatzeko gaitasuna du.

every time it infects a cell.

Despite the remarkable progress we've made in reversing the epidemic,

Birus honi aurre egitego garapen esanguratsuak lortu baditugu ere,

the truth is that we are just a few viral mutations away from disaster.

egia esan hondamenetik mutazio gutxi batzuetara gaude.

HIESAren aldakortasuna ikusi ahal izateko,

To appreciate the profound way in which HIV transforms itself

birusa erreproduzitzen den bakoitzean,

every time it reproduces,

let's make a genetic comparison.

goazen alderatze genetiko bat egitera:

If we look at the DNA variation among humans of different races

Giza arrazen arteko DNA ezberdintasunei begiratzen badiegu,

from different continents,

kontinenteetan zehar,

the actual DNA difference is only 0.1 percent.

DNA ezberdintasuna %0,1 baino ez da.

If we look at the genetic difference

Gizakien eta tximinoen artean %7koa da.

between humans, great apes, and rhesus macaques,

that number is seven percent.

In contrast, the genetic difference between HIV subtypes

Alderantziz, ezberdinatsun genetikoa HIESaren moten artean

from different patients

gaixo ezberdinen artean %35koa izatera heldu daiteke.

may be as much as 35 percent.

Within a person infected with HIV,

HIESArekin kutsatuta dagoen pertsona batean

the genetic difference between an infecting mother virus

ama birusa eta bere seme birusen arteko ezberdintasun genetikoa

and subsequent daughter viruses

%5rainokoa dela frogatu da.

has been shown to be as much as five percent.

This is the equivalent of a gorilla giving birth to a chimpanzee,

Gorila batek seme tximpanze bat izatearen balio bera du.

Eta segidan orangutan bat izatea,

then to an orangutan,

then to a baboon,

gero babuino bat,

then to any random great ape within its lifetime.

eta gero edozelako tximino espezie bat izatea.

There are nearly 100 subtypes of HIV,

Gutxigorabehera 100 HIES mota daude

with new subtypes being discovered regularly.

eta maiz mota berriak aurkitzen dira.

HIV in the developed world is almost all of one subtype:

HIESa mundo garatuan ia mota batekoa baino ez da: B mota.

subtype B.

HIESari aurre egiteko dakigun ia guztia B motaren ikerketei dagokie.

Mostly everything we know and do to treat HIV

is based on studies on subtype B,

Baina mundu osoko kasuen %12 baino ez da.

even though it only accounts for 12 percent

of the total number of cases of HIV in the world.

Ezberdintasun genetikoaren ondorioz, HIESaren moten arteko batzuk

But because of the profound genetic difference

among different subtypes,

some subtypes are more likely to become drug-resistant

drogei aurre egiteko gaitasun handiagoa dute

or progress to AIDS faster.

edota azkarrago garatzen dira.

We discovered that the explosion of HIV cases in the Philippines

Filipinetako HIES kasuen eztanda, mendebaldeko B motatik

is due to a shift from the Western subtype B

Asia hego-ekialdeko AE mota agresibo baterako

to a more aggressive Southeast Asian subtype AE.

aldaketari dagokiola aurkitu dugu.

We are seeing younger and sicker patients

Gaixo gazteagoak eta kaltetuagoak ikusten ari gara

with high rates of drug resistance.

sendagaiei erristentzia handiagoarekin.

Initial encroachment of this subtype

Mota honen lehen aztarnak

is already occurring in developed countries,

jadanik ikusten ari dira herrialde garatuetan,

including Australia, Canada and the United States.

hots Australia, Kanada eta Estatu Batuak.

We may soon see a similar explosion of cases in these countries.

Denbora gutxira kasu eztanda berdin bat ikusteko probabilitate handia dago.

HIESarekin bukatu dugula pentsatzen dugun bitartean,

And while we think that HIV is done

eta gaixotasun honen bolada joan egin dela pentsatzen dugun bitartean,

and that the tide has turned for it,

just like with real tides, it can come right back.

berriro agertzea izan liteke.

In the early 1960s, malaria was on the ropes.

1960ko hamarkadan, malaria ia garaitua zegoen.

Kasuen kopurua behera zihoan bitartean,

As the number of cases dropped,

people and governments stopped paying attention.

jendeak eta gobernuek jaramon egiteari utzi zioten.

The result was a deadly resurgence of drug-resistant malaria.

Ondorioz sendagai-erresistentzia zuen malaria baten berragerraldi bat izan zen.

We need to think of HIV

HIESean pentsatzean

not as a single virus that we think we've figured out,

ez dugu garaitu dugun birus bakar batean pentsatu behar,

but as a collection of rapidly evolving and highly unique viruses,

baizik eta azkar garatzen ari den birus talde anitz batean,

non birus bakoitzak hurrengo epidemia hilkorra sortu dezakeen.

each of which can set off the next deadly epidemic.

We are incorporating more powerful and new tools

Erreminta berri eta indartsuagoak sortzen ari gara

to help us detect the next deadly HIV strain,

hurrengo HIESaren mota hilkorra detektatu ahal izateko

and this needs to go hand in hand with urgent research

eta honek premiazko ikerketa baten ondoan jorratzeko beharra du.

on the behavior and proper treatment of non-B subtypes.

B mota ez diren moten bilakaera eta sendatzeko modua ikertzeko.

We need to convince our governments

Gobernuei eta agentziei

and our funding agencies

buruan sartu behar diegu

that HIV is not yet done.

HIESarekin ez dugula bukatu.

Over 35 million people have died of HIV.

HIESak 35 milioi pertsona baino gehiago hil ditu

We are on the verge of an AIDS-free generation.

HIESarik gabeko generazio bat lortzeko aukera dugu.

We need to pay attention.

Kontuz ibili behar gara.

We need to remain vigilant

Erne ibili eta horrela jarraitu behar dugu

and follow through.

Otherwise, millions more will die.

Bestela, milioika pertsona gehiago hilko dira.

Thank you.

Eskerrik asko.

(Applause)

(Txaloak)