The dangerous evolution of HIV | Edsel Salvaña

翻译人员: Tianqi Du 校对人员: Echo Sun

The Philippines: an idyllic country

菲律宾：一个田园般的国家，

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

这里拥有着这个星球上最清澈的水，最蓝的天。

It is also the epicenter

但是它也是这个世界上，

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

艾滋病蔓延最快的地区之一。

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

表面上看，我们似乎只是在这个方面还不成熟。

However, the reasons for our current epidemic

但其实，造成我们目前流行病的原因

are much more complicated

远比我们所想的要复杂得多，

and may foreshadow a global resurgence of HIV.

还有可能预示着艾滋病毒的全球性复苏。

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

虽然世界上新感染的艾滋病毒病例在持续下降，

this trend may be short-lived

但当下一波更具有侵略性和抵抗力的病毒到来时，

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

这种趋势有可能是短暂的。

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

艾滋病毒有可能在每次感染细胞时，

every time it infects a cell.

转变成一种不同的新型病毒。

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

尽管我们在扭转这一流行病方面取得了显著的进展，

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

但事实上，我们离灾难只有几个病毒变异。

To appreciate the profound way in which HIV transforms itself

想要理解艾滋病毒在每次繁殖过程中，

every time it reproduces,

是如何改变自身的，

let's make a genetic comparison.

我们可以来做一个基因比较。

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

如果我们观察来自不同大陆，

from different continents,

不同人种之间的DNA变异，

the actual DNA difference is only 0.1 percent.

实际DNA差异仅为百分之0.1。

If we look at the genetic difference

如果我们观察人类，

between humans, great apes, and rhesus macaques,

类人猿和猕猴之间的基因差异，

that number is seven percent.

差异值为百分之7。

In contrast, the genetic difference between HIV subtypes

相比之下，不同患者的艾滋病毒亚型之间，

from different patients

基因差异值，

may be as much as 35 percent.

可能高达百分之35。

Within a person infected with HIV,

在感染艾滋病毒的人中，

the genetic difference between an infecting mother virus

感染母病毒的人，

and subsequent daughter viruses

与随后感染子病毒的人，

has been shown to be as much as five percent.

基因差异值高达百分之5。

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

这就好比一只大猩猩生下了一只黑猩猩，

然后生下一只猩猩，

then to an orangutan,

then to a baboon,

然后又生下一只狒狒，

then to any random great ape within its lifetime.

生下任何可能的猿类动物。

There are nearly 100 subtypes of HIV,

艾滋病毒有将近100种亚型，

with new subtypes being discovered regularly.

新的亚型被定期发现。

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

在发达国家，艾滋病毒大多都是一种亚型：

subtype B.

亚型B.

Mostly everything we know and do to treat HIV

我们所知与所做的治疗，

is based on studies on subtype B,

都是基于对B型病毒的研究，

even though it only accounts for 12 percent

尽管这种B型病毒在世界范围内，

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

只占艾滋病毒病例总数的百分之12。

But because of the profound genetic difference

但是由于在不同亚型之间，

among different subtypes,

存在着明显的基因差异，

some subtypes are more likely to become drug-resistant

一些亚型会更具有抗药性，

or progress to AIDS faster.

也有可能更快地发展为艾滋病。

We discovered that the explosion of HIV cases in the Philippines

我们发现，菲律宾艾滋病的病例激增的原因，

is due to a shift from the Western subtype B

是因为病毒从西方的B型，

to a more aggressive Southeast Asian subtype AE.

转变为了更具攻击性的东南亚AE型病毒。

We are seeing younger and sicker patients

我们发现那些更年轻，病得更严重的病人，

with high rates of drug resistance.

他们的耐药率很高。

Initial encroachment of this subtype

在一些发达国家中，

is already occurring in developed countries,

一些亚型的初始侵害已经在发生，

including Australia, Canada and the United States.

包括澳大利亚，加拿大，美国。

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

我们有可能很快就会在这些国家中看到相同病例的增激。

And while we think that HIV is done

当我们认为艾滋病毒已经被遏制，

and that the tide has turned for it,

而且趋势也有所扭转，

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

就像真的控制住了一样，但它依然有可能再复发。

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

在上世纪六十年代初，疟疾即将绝迹。

As the number of cases dropped,

随着病例数量的减少，

people and governments stopped paying attention.

人们及政府也对此放松警惕。

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

造成的结果是抗药性疟疾死灰复燃。

We need to think of HIV

我们不应该把艾滋病毒视为

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

我们所认为已经发现的单一病毒，

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

而是应该把它视为一个快速进化， 极其独特的病毒集合体，

each of which can set off the next deadly epidemic.

每一种病毒都会引发下一个致命的流行病。

We are incorporating more powerful and new tools

我们正在研发更有效的新器械，

来帮助我们检测下一个致命的艾滋病毒株，

to help us detect the next deadly HIV strain,

and this needs to go hand in hand with urgent research

这需要我们对非B型病毒的特征 ，

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

以及适当的治疗方案同时加紧速度进行研究。

We need to convince our governments

我们要让我们的政府，

以及资助机构意识到，

and our funding agencies

that HIV is not yet done.

艾滋病毒还没有完全遏制。

Over 35 million people have died of HIV.

有超过3500万的人死于艾滋病，

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

我们即将迎来无艾滋的时代，

We need to pay attention.

我们需要关注艾滋病，

We need to remain vigilant

并保持警惕，

and follow through.

然后一直坚持到底。

Otherwise, millions more will die.

否则，仍会有数以百万计的人因艾滋病死去。

Thank you.

谢谢！

(Applause)

（掌声）