The dangerous evolution of HIV | Edsel Salvaña

Translator: 潘 可儿 Reviewer: Sylvia He

The Philippines: an idyllic country

菲律賓係一個田園國家

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

擁有地球上最乾淨嘅水和最藍嘅天空

It is also the epicenter

同時都係世界上

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

HIV 傳染病例增長最快嘅重災區之一

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

表面上睇，菲律賓 似乎只係一個遲爆發 HIV 嘅國家

However, the reasons for our current epidemic

但係，事實上造成我哋疫情嘅原因

are much more complicated

要複雜得多

and may foreshadow a global resurgence of HIV.

而且疫情可能預示著 HIV 會再次喺全球爆發

但全球 HIV 總體新病例數 正持續下降

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

this trend may be short-lived

呢個趨勢可能唔會持續

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

但係，下一輪嘅病毒 將會更強烈、抗藥性更强

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

每當 HIV 侵染一個細胞

佢都可能將自己變異成一種新病毒

every time it infects a cell.

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

雖然我哋同 HIV 傳染病嘅仗 已經取得顯著進展

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

事實上，只要病毒再變異幾次 災難就可能會再次來襲

To appreciate the profound way in which HIV transforms itself

為咗更加清楚咁瞭解 HIV 每次增殖后顯著嘅基因變異

every time it reproduces,

let's make a genetic comparison.

我哋嚟做一個基因對比

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

如果我哋去睇各個大洲

唔同人種之間嘅 DNA 多樣性

from different continents,

the actual DNA difference is only 0.1 percent.

事實上只有百分之零點一嘅差別

If we look at the genetic difference

如果係人類、人科猿、 普通獼猴三者

between humans, great apes, and rhesus macaques,

that number is seven percent.

基因差別係百分之七

In contrast, the genetic difference between HIV subtypes

相比之下，喺唔同病人身上嘅 HIV 亞種

from different patients

基因差別會高達百分之三十五

may be as much as 35 percent.

Within a person infected with HIV,

同一個 HIV 患者身上

the genetic difference between an infecting mother virus

親代同子代病毒之間嘅基因差異

and subsequent daughter viruses

has been shown to be as much as five percent.

有百分之五噉多

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

親子代之間噉大嘅基因變異 就相當於大猩猩生黑猩猩

then to an orangutan,

再生紅猩猩

then to a baboon,

然後生狒狒

then to any random great ape within its lifetime.

又再喺生命之中生任何一種人猿

There are nearly 100 subtypes of HIV,

HIV 病毒有將近一百個亞種

with new subtypes being discovered regularly.

仲有新亞種被持續發現

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

發達國家嘅 HIV 幾乎 都係同一個亞種︰

subtype B.

B 亞種

Mostly everything we know and do to treat HIV

我哋對 HIV 一切嘅瞭解同治療

is based on studies on subtype B,

幾乎都係基於對 B 亞種嘅研究

even though it only accounts for 12 percent

雖然佢只占全世界 HIV 病例 嘅百分之十二

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

But because of the profound genetic difference

但由於唔同亞種之間 顯著嘅基因差異

among different subtypes,

some subtypes are more likely to become drug-resistant

一啲亞種產生抗藥性嘅可能性會更高

or progress to AIDS faster.

甚至會更快發展成愛滋病

We discovered that the explosion of HIV cases in the Philippines

我哋發現菲律賓嘅 HIV 病例嘅爆發

is due to a shift from the Western subtype B

係由於西部 B 亞種

to a more aggressive Southeast Asian subtype AE.

變異成一種更強勁嘅 東南亞 AE 亞種

We are seeing younger and sicker patients

我哋發現更後生、病情更嚴重嘅病人

with high rates of drug resistance.

有更高嘅抗藥性比率

Initial encroachment of this subtype

呢個亞種已經入侵發達國家

is already occurring in developed countries,

including Australia, Canada and the United States.

包括澳洲、加拿大同美國

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

可能好快，類似菲律賓嘅 HIV 疫情 就會喺呢啲國家發生

And while we think that HIV is done

如果我哋以為 HIV 大潮已經退去 就錯啦

and that the tide has turned for it,

事實上佢會返嚟

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

就好似真正嘅潮水會回潮

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

十八世紀六十年代早期 瘧疾大潮消退

As the number of cases dropped,

病例數下降

people and governments stopped paying attention.

人們同政府轉移咗注意力

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

結果抗藥性瘧疾又捲土重來

We need to think of HIV

我哋唔可以將 HIV 睇成

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

一種已經瞭解透徹嘅單一病毒

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

而係一系列進化快速、高度獨特嘅病毒

each of which can set off the next deadly epidemic.

其中任何一種都有可能 引發下一次致命嘅疫情

We are incorporating more powerful and new tools

依家我哋藉助更強大、更新嘅工具

to help us detect the next deadly HIV strain,

去檢測下一個致命 HIV

and this needs to go hand in hand with urgent research

噉又需要同時進行 對非 B 亞種嘅緊急研究同適當治療

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

We need to convince our governments

我哋需要令我哋嘅政府、基金會相信

and our funding agencies

that HIV is not yet done.

人類同 HIV 嘅惡戰仍未結束

Over 35 million people have died of HIV.

超過三千五百萬人死於 HIV

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

我哋將邁入「零愛滋」嘅年代

We need to pay attention.

我哋需要時刻關注

We need to remain vigilant

我哋需要保持警惕，及時跟進

and follow through.

Otherwise, millions more will die.

唔係嘅話，仲會有千千萬萬個人喪生

Thank you.

多謝

(Applause)

（掌聲）