The dangerous evolution of HIV | Edsel Salvaña

Translator: Nika Kotnik Reviewer: Matej Divjak

The Philippines: an idyllic country

Filipini: idilična država,

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

kjer lahko najdemo najbolj čisto vodo in najbolj modro nebo na planetu.

It is also the epicenter

Je pa tudi epicenter

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

ene izmed najhitreje rastočih HIV epidemij na svetu.

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

Na površju se zdi, da smo samo pozno začeli.

However, the reasons for our current epidemic

A razlogi za trenutno epidemijo

are much more complicated

so veliko bolj zapleteni,

and may foreshadow a global resurgence of HIV.

in morda naznanjajo ponovno globalno pojavljanje HIV-a.

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

Medtem ko se pojavljanje novih primerov HIV-a po svetu zmanjšuje,

this trend may be short-lived

gre morda za kratkoročen trend

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

pred prihodom naslednjega vala agresivnih in odpornih virusov.

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

HIV se lahko spremeni v nov in drugačen virus,

every time it infects a cell.

vsakič ko okuži neko celico.

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

Ne glede na neverjeten napredek, ki smo ga dosegli pri zaviranju epidemije,

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

smo v resnici le nekaj mutacij stran od katastrofe.

To appreciate the profound way in which HIV transforms itself

Da bi lahko cenili, kako temeljito se HIV preobrazi vsakič,

every time it reproduces,

ko se podvoji,

let's make a genetic comparison.

naredimo genetsko primerjavo.

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

Če pogledamo variacijo človeške DNK med različnimi rasami

from different continents,

z različnih kontinentov,

the actual DNA difference is only 0.1 percent.

je razlika med DNK le 0,1 odstotka.

If we look at the genetic difference

Če pogledamo genetsko razliko

between humans, great apes, and rhesus macaques,

med ljudmi, velikimi opicami, in rhesus opicami,

that number is seven percent.

le ta znaša 7 odstotkov.

In contrast, the genetic difference between HIV subtypes

Za primerjavo, genetska razlika med podtipi HIV-a

from different patients

različnih pacientov

may be as much as 35 percent.

je lahko tudi 35-odstotna.

Within a person infected with HIV,

V osebi, okuženi z virusom HIV,

the genetic difference between an infecting mother virus

znaša genetska razlika med prvotnim virusom okužbe

and subsequent daughter viruses

in hčerinskimi virusi

has been shown to be as much as five percent.

tudi do pet odstotkov.

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

To je enako, kot če bi gorila rodila šimpanza,

then to an orangutan,

potem orangutana,

then to a baboon,

nato pavijana,

then to any random great ape within its lifetime.

nato naključno veliko opico, vse to v svojem življenju.

There are nearly 100 subtypes of HIV,

Obstaja skoraj 100 podvrst HIV-a,

with new subtypes being discovered regularly.

ob tem pa redno odkrivamo nove podtipe.

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

HIV v razvitem svetu je skoraj ves samo ene podvrste:

subtype B.

Podvrste B.

Mostly everything we know and do to treat HIV

Večina vsega, kar vemo in počnemo, da bi pozdravili HIV,

is based on studies on subtype B,

je osnovana na študijah, narejenih na podtipu B,

even though it only accounts for 12 percent

čeprav predstavlja le 12 odstotkov

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

vseh primerov virusa HIV na svetu.

But because of the profound genetic difference

Ampak zaradi pomembne genetske razlike

among different subtypes,

med različnimi podtipi,

some subtypes are more likely to become drug-resistant

je za nekatere podtipe bolj verjetno, da bodo postali odporni na zdravila

or progress to AIDS faster.

ali hitreje napredovali v AIDS.

We discovered that the explosion of HIV cases in the Philippines

Odkrili smo, da se je eksplozija primerov HIV-a na Filipinih

is due to a shift from the Western subtype B

zgodila zaradi premika z zahodnega podtipa B

to a more aggressive Southeast Asian subtype AE.

na bolj agresiven podtip AE iz jugovzhodne Azije.

We are seeing younger and sicker patients

Videvamo mlajše in bolj bolne paciente

with high rates of drug resistance.

s pogostejšo rezistenco na zdravila.

Initial encroachment of this subtype

Prvotna širitev tega virusa

is already occurring in developed countries,

se že dogaja v razvitih državah,

including Australia, Canada and the United States.

vključno z Avstralijo, Kanado in Združenimi državami.

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

Morda bomo kmalu videli eksplozijo primerov v teh državah.

And while we think that HIV is done

In medtem ko mislimo, da smo s HIV-om opravili

and that the tide has turned for it,

in da je val že odšel,

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

se lahko kot pravi val spet vrne.

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

V 60-ih je bilo tako z malarijo.

As the number of cases dropped,

Ko se je število primerov zmanjšalo,

people and governments stopped paying attention.

ljudje in vlada niso bili več pozorni.

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

Rezultat je bila smrtonosna vrnitev malarije, odporne na zdravila.

We need to think of HIV

Ne smemo razmišljati o HIV-u,

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

kot o enem samem virusu, ki ga dobro poznamo,

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

ampak kot o skupini hitro spreminjajočih se in unikatnih virusov,

each of which can set off the next deadly epidemic.

in vsak od njih lahko zaneti naslednjo smrtonosno epidemijo.

We are incorporating more powerful and new tools

Vključujemo močnejša in novejša orodja

to help us detect the next deadly HIV strain,

v iskanje naslednjega smrtonosnega seva virusa HIV

and this needs to go hand in hand with urgent research

in to mora biti z roko v roki z nujnim raziskovanjem

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

delovanja in zdravljenja ostalih podtipov.

We need to convince our governments

Prepričati moramo naše vlade

and our funding agencies

in naše agencije za financiranje,

that HIV is not yet done.

da s HIV-om še nismo opravili.

Over 35 million people have died of HIV.

Več kot 35 milijonov ljudi je umrlo zaradi HIV-a.

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

Smo na robu generacije brez AIDS-a.

We need to pay attention.

Moramo biti pozorni.

We need to remain vigilant

Moramo ostati oprezni

and follow through.

in stvari izpeljati do konca.

Otherwise, millions more will die.

Če ne, bo umrlo še na milijone ljudi.

Thank you.

Hvala.

(Applause)

(Aplavz)