艾滋病30年:回顾过去、展望未来
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艾滋病30年:回顾过去、展望未来

There was no fanfare on May 20, 1983 whenScience published what is undoubtedly among the most important medical papers of the 20th century. 1、1983年5月,当《科学》杂志发表了这篇毫无疑问被认为20世纪最重要的论文时,并没有引起很大的关注。

2、在一如既往的枯燥的文章里,来自法国巴斯德研究所得研究者描述了一个新型的逆转录病毒,与这个病毒相关的疾病被称为淋巴结病,简写为LAV 。

It was, they reported, a "typical type-C RNA tumor virus" with a tropism for T-lymphocytes and was similar to -- but clearly distinct from -- human T-cell leukemia viruses, which had recently been discovered. 3、他们报道说,最近研究发现,这个病毒是T 淋巴细胞趋向的典型的C 型RNA 肿瘤病毒,并且与人类T 细胞白血病病毒很相似(但是也有很明显的不同)。

Today, we know it simply as HIV.

4、今天,我们都知道这个病毒就被简单成为HIV 。 That paper made very little immediate impression, according to Françoise Barré-Sinoussi, PhD, of the Pasteur institute, who was the lead author and who later shared the 2008 Nobel prize in medicine for the discovery with the senior author Luc Montagnier, PhD.

5、根据巴斯德研究所的医学博士Françoise Barré-Sinoussi 说,那篇论文当时没有给人留下太深的印象Françoise 博士同时也是这个病毒发现的首席作者,并且与资深作者及医学哲学博士Luc Montagnier因此病毒的发现分享了2008年的诺贝尔医学奖 Partly that was because HIV/AIDS -- although mysterious and deadly -- was not yet seen as a global threat.

6、部分原因是因为尽管HIV/ARDS很神秘和具有致死性,但是并没有被视为全球的威胁。

Finding the virus "was not just an academic problem," Barré-Sinoussi told MedPage Today. "But there were only a few cases and we did not yet have the idea of the magnitude of the infection, the magnitude of the epidemic."

7、发现这个病毒“并不仅是个学术问题。”Barré-Sinoussi 告诉今日医学新闻说,“但是仅有几个这样的病例,我们仍然缺乏关于此病的感染程度及流行病学范围的认识”。

And the scientific community wanted more before breaking out the champagne. "We had to accumulate more data about the links between the virus itself and the disease," she said.

8、但在开香槟庆祝之前科学委员会还需要更多的数据。“我们不得不积累更多的关于病毒和这个疾病之间关系的数据。”她说。

For those studying the issue, "it was a very important paper," commented Anthony Fauci, MD,

director of the National Institute for Allergy and Infectious Diseases.

9、对于那些研究这个课题的人来说,“这是一篇非常重要的论文,”国家过敏和感染疾病研究中心的医学博士Anthony Fauci评论说。 But it wasn't a "slam-dunk," he told MedPage Today. "Although it was clear they had isolated the virus ... there was no way to definitively diagnose people who were presenting at hospitals" so there was a missing link. 10、他告诉今日医学新闻说:“尽管很明确他们已经分离出了这种病毒,但是这个研究的回报并不可观。现对于入院的患者还没有一个明确的诊断方法。”所以疾病和病毒之间就缺乏了联系。 It was still necessary to demonstrate epidemiological links between the virus and people with AIDS, a demonstration that came the next year with papers by Robert Gallo, MD, then at the National Cancer Institute, and colleagues, Fauci said.

11、Fauci 说,流行病学上证实AIDS 患者和病毒之间的联系还是很有必要的,这个证明在第二年由国家癌症研究中心的医学博士Robert Gallo和他的同事发表出来。

That research provided "epidemiological and serological proof that the virus was unequivocally associated with the disease that we were just then starting to call AIDS," he said. 12、他说,那个研究提供了“流行病学及血清学的证据证实病毒与这个刚刚被我们命名的ARDS 疾病有明确联系。”

But as that data accumulated, it became evident that French discovery was indeed significant -- the cause of the disease was finally known. Researchers optimistically talked about vaccines and cures as if they would be -- not easy, perhaps -- but not out of reach.

13、但是随着数据的积累,这些数据证明法国的发现确实很有意义。疾病的原因最终被明确。

研究者们乐观的讨论到疫苗和治愈问题,这好像不太容易实现,但或许也并不是不可能。

the 30th anniversary of that discovery and there is a renewed sense of optimism about the pandemic.

14、这周在巴黎,巴斯德研究所将举办一个庆祝病毒发现30周年的国际座谈会,这对疾病的流行将迎来一个全新意义的乐观时代。

But there is also an understanding that HIV remains a tough challenge, Fauci said. He is to deliver a keynote talk and part of its title sums up the past three decades of HIV/AIDS research: "much accomplished, much to do." 15、但是现在对于HIV 的理解依然是一个艰难的挑战,Fauci 说。他发表了一个主题演讲,部分主题总结了过去30年对于HIV/ARDS的研究状况。“完成的成就很多,但也有很多未完成的任务”。

Among the "much to do," Fauci said, is to crack the tough problems of a vaccine and a cure -- the same tough problems that have dogged the field since 1983.

16、Fauci 说,在这些未完成的任务中主要就是打破没有疫苗及无法治愈的艰难问题,自1983年来这个艰难的问题就一直伴随着失败。

At that time, he said, "we didn't realize that HIV was such a difficult virus" and it wasn't yet clear that it would not easily surrender to medical science. 17、那时,他说:“我们没有意识到HIV 是一个如此难对付的病毒。”并且当时人们还不清楚HIV 难以被医学科学所攻克。

On the vaccine front, for instance, the usual approach is to try to mimic nature -- cause an immune response that first halts, then clears, and then protects against the disease.But in HIV, that's not nature's way, Fauci noted. With vanishingly few exceptions, no one mounts an immune response that stops, clears, and protects against HIV. 18、比如说,在疫苗方面,通常的做法是模仿病原菌的天然属性,使其引起一个只发生一次就终止的免疫反应,然后将其清除,而后保护机体抵抗HIV 。但是对HIV 而言,并不存在自然的方式,Fauci 提到。 随着仅存的期望越来越渺茫,没有人发现一种能够阻止、清除和防护HIV 病毒的免疫反应。

"If you're going to develop a vaccine you're going to have to do better than nature," he said.

19、“如果你要打算开发一种疫苗,你就要不得不把疫苗做的比病毒的天然属性还要好。”他说。

So far, of course, researchers have not managed to do that.

20、当然,到目前为止,研究者还没有设法完成此事。

Barré-Sinouss i ,Along with the 20,000-foot view that Fauci brings to the table, the Paris symposium will hear more about the basic science of HIV and its interaction with the immune system, which 30 years later, is still not completely understood, according to Barré-Sinoussi. 21、据Barré-Sinoussi 说 ,伴随着Fauci 摆到桌面上的高层次观点的提出,巴黎座谈会上将听到更多的关于HIV 的基础研究以及其相关的免疫机制,30年过去了,这些问题依然没有完全清楚。

"We need to have some new discoveries in the field of immunology," she said. "There are still some missing pieces of the puzzle."

22、她说,“关于免疫方面的,我们还需要更多新发现,这个难题依然存在许多缺失的方面”。

but they can control the virus without the aid of antiretroviral medications.

23、Barré-Sinoussi 说,她也期望更多地了解有关所谓的“功能性治愈”—今年年初的标题新闻。在功能性治愈后,病人仍然存在感染,但他们可以在不用抗逆转录病毒药物的情况下控制病毒。

Exactly how that can be made to happen reliably remains an open question that -- if it could be answered -- would change the face of the HIV/AIDS pandemic.

24、可靠的达成功能性治愈的具体方式仍然是一个开放的问题。如果这一问题得以解决(前提是可以解决),将改变HIV/AIDS的全貌。

She's looking forward to reports on the mechanisms by which HIV establishes itself in the body

and then persists despite antiretroviral medications that prevent it from replicating.

25、她正在期待有关HIV 在人体内自我组建并在可阻止其复制的抗逆转录病毒药物存在时存活的机制的报告。

And there will be more details at the symposium about vaccine research, including a debate on

26、并且讨论会上将有更多有关疫苗研究的细节的探讨,包括有关4年前一项重大试验的部分性成功和最近另一项试验的失败的讨论。

What Barré-Sinoussi is not expecting is anything dramatic. An announcement of a breakthrough "would be wonderful, but I don't think we will have that."

27、Barré-Sinoussi 并不期望有任何激动人心的发现。“若能发表取得重大突破的声明当然是极好的,但是我并不认为会取得这样的突破。

On the other hand, no one immediately recognized the breakthrough by her and her colleagues 30 years ago, so time may tell.

28、另一方面,30年前也没有人立即意识到她和她的同事取得的突破性进展,所以也许一切都有待时间去证明。