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【轉(zhuǎn)帖】德國醫(yī)生宣布“治愈”一例HIV患者 已有19人參與
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Reuters) - German researchers who used a bone marrow transplant to treat a cancer patient with the AIDS virus, have declared him cured of the virus -- a stunning claim in a field where the word "cure" is barely whispered. The patient, who had both HIV infection and leukemia, received the bone marrow transplant in 2007 from a donor who had a genetic mutation known to give patients a natural immunity to the virus. Nearly four years after the transplant, the patient is free of the virus and it does not appear to be hiding anywhere in his body, Thomas Schneider of Berlin Charite hospital and colleagues said. "Our results strongly suggest that cure of HIV has been achieved in this patient," they wrote in the journal Blood. AIDS researchers have rejected the approach on any kind of scale for patients with HIV. A bone marrow transplant is a last-ditch treatment for cancers such as leukemia. It requires destruction of a patient's own bone marrow -- itself a harrowing process -- and then a transplant from a donor who has a near-exact blood and immune system type. Months of recovery are needed while the transplant grows and reconstitutes the patient's immune system. "It's not practical and it can kill people," said Dr. Robert Gallo of the Institute of Human Virology at the University of Maryland, who helped discover the human immunodeficiency virus that causes AIDS. "It is possibly a cure, that's for sure, you won't know for absolute sure until the person dies and undergoes extreme PCR (genetic) analysis of post-mortem tissue." The mutation affects a receptor, a cellular doorway, called CCR5, that the AIDS virus uses to get into the cells it infects. Since the 1990s scientists have known that some people, mostly of Northern European descent, have the mutation and are rarely infected with HIV. "They are uninfectable, virtually," Gallo said. Some researchers are working on the idea of gene therapy to treat or try to cure HIV, but the technology is still in experimental stages. "I don't want to throw cold water on an interesting thing, but that's what it is -- an interesting thing," Gallo said. Schneider's team has been following the patient, taking samples from his colon, liver, spinal fluid and brain as he developed various conditions that justified the tests. They tested all these samples for evidence of the virus, which can be difficult to detect unless it is actively infecting cells. All these places are suspected "reservoirs" where HIV can hide out for years, to rebound in patients who stop taking drugs that suppress the infection. This patient appears to have a fully functioning immune system, they found, which appears genetically identical to cells from the donor -- not the patient's own immune cells. Schneider's team found no evidence of HIV anywhere. "From these results, it is reasonable to conclude that cure of HIV infection has been achieved in this patient," they wrote. The AIDS virus infects 33 million people globally and has killed more than 25 million since the pandemic began in the 1980s. Cocktails of strong drugs can suppress the virus, keeping patients healthy and reducing the chance they will infect others, but there is no vaccine. 編譯： 路透社訊——德國研究者宣稱在通過骨髓移植治療一位感染AIDS病毒的白血病患者的同時(shí)，治愈了該患者的病毒感染——此項(xiàng)驚人報(bào)道中的“治愈”一詞，在該領(lǐng)域幾乎只是個(gè)傳聞。 柏林Charite 醫(yī)院的Thomas Schneider醫(yī)生和他的同事們發(fā)表在最近一期《血液》雜志中的文章報(bào)告了一例合并HIV感染的白血病患者，在2007年接受過骨髓移植后的近4年時(shí)間里，不再有病毒感染而且似乎在體內(nèi)也沒有病毒潛伏。骨髓的捐獻(xiàn)者攜帶一種可使患者對(duì)HIV病毒具有天然免疫性的基因突變。該研究結(jié)果強(qiáng)烈提示HIV的治愈已經(jīng)在這例患者中實(shí)現(xiàn)。 骨髓捐獻(xiàn)者攜帶的這種基因突變可影響一種叫做CCR5的細(xì)胞通道受體，AIDS病毒常通過這種通道進(jìn)入并感染細(xì)胞。上世紀(jì)90年代起科學(xué)家們發(fā)現(xiàn)，在某些人群中，主要是北歐系人群攜帶該突變，很少發(fā)生HIV感染。事實(shí)上，攜帶這種基因突變的人不可被HIV感染。已經(jīng)有研究者們正在設(shè)法通過基因療法來治療或試圖治愈HIV，但這種技術(shù)仍處于實(shí)驗(yàn)階段。 Schneider醫(yī)生的研究小組一直在跟蹤隨訪該患者，并隨著疾病的發(fā)展從患者的結(jié)腸、肝臟、腦脊液和腦組織中進(jìn)行采樣，并檢測所有這些樣本中是否存在病毒感染的證據(jù)。在這樣的檢測中除非是活性感染的細(xì)胞，否則很難被檢出。所有這些采樣部位都是HIV可疑潛伏之處。HIV病毒可能潛伏數(shù)年，并在在患者停止服用抗感染藥物后重新開始復(fù)制。Schneider醫(yī)生和他的同事們沒有發(fā)現(xiàn)任何HIV感染的證據(jù)，卻發(fā)現(xiàn)該患者表現(xiàn)出了健全的免疫系統(tǒng)功能，在遺傳上與骨髓捐獻(xiàn)者的細(xì)胞相似——而非患者自身的免疫細(xì)胞。從這些結(jié)果來看，有理由得出結(jié)論：HIV感染的治愈在這例患者中實(shí)現(xiàn)了。 但AIDS研究者們反對(duì)將該方法用于任何HIV感染的患者。骨髓移植僅作為白血病這類癌癥的最后治療手段。這種治療本身就是一個(gè)痛苦的過程——需要破壞患者自身的骨髓，然后從一位血型和免疫型幾近相同的捐贈(zèng)者獲得骨髓移植。免疫缺陷病毒導(dǎo)致AIDS的發(fā)現(xiàn)者之一，美國馬里蘭大學(xué)人類病毒研究所的Robert Gallo博士認(rèn)為這種方法并不實(shí)用而且可能致命。他指出“這有可能是治愈，可以肯定；但并不能完全肯定，除非這個(gè)患者死后進(jìn)行徹底的死后組織PCR（遺傳）分析。” 自上世紀(jì)80年代AIDS病毒感開始染流行以來，全球共有3300萬人感染該病毒，并有超過2500萬人死于這種感染。含有強(qiáng)力抗病毒藥物的雞尾酒療法可抑制病毒復(fù)制、保持患者健康并減少傳染他人的機(jī)會(huì)，但至今尚無疫苗。 http://news.dxy.cn/bbs/topic/19007901?tpg=1&age=0 |
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