新闻背景：2011年12月1日全球第24个“世界艾滋病日”前夕， 150余家媒体的编辑记者齐聚广州，参加由新闻出版总署举办的第三批全国报刊媒体禁毒防艾宣传培训活动，新闻出版总署新闻报刊司发起的“全国报刊禁毒防艾公益广告征集巡展专项行动”同时启动。
阅读提要
-艾滋病毒在布朗体内已寄居十多年，雪上加霜的是，几年之后他又被查出患有白血病，医生不得不为他进行骨髓移植，迪尔医生大胆尝试一箭双雕治愈艾滋病和白血病。
-艾滋病毒进入免疫系统，必须同时结合免疫细胞表面的两种物质CD4和CCR5。就像一把钥匙一样，必须同时具有两个孔，才能打开免疫细胞的大门。不感染艾滋病的人群幸运之处就是缺失CCR5基因。
-在与布朗配型成功的60名骨髓捐献者中，就恰好有一位缺失CCR5基因的人！布朗通过成功的骨髓移植，重建的免疫系统正好也缺失CCR5基因，实现了白血病艾滋病同时治愈。
-2009年，布朗的主治医生在《新英格兰医学》杂志上发表文章，很小心地把布朗的状况描述为“通过骨髓移植长期控制了艾滋病毒”。直到一年后在《血液》上，他们才正式底气十足地宣称：艾滋病人布朗被治愈了！
-第二布朗还会出现吗？清华大学张林琦教授的答案是“‘布朗’还会出现，但绝非易事。”因为布朗同时是一个白血病患者，且非常幸运地找到了对艾滋病毒有先天免疫力的骨髓捐献者，另外还有足够的钱。
艾滋病人被治好了，而且是彻底根治了，体内已经没有艾滋病毒了！
这个幸运的家伙是一个43岁的美国人——布朗，是去年12月在德国治好的。更为滑稽的是，他的艾滋病之所以能被治愈，其实是因祸得福，因为他同时患上了要命的白血病。
这个故事听起来的确像是编造的虚构电影剧本，但国际顶尖医学期刊《血液》杂志告诉全世界：这是个真实的病例。
要把白日梦实现的医生
奇迹发生在德国柏林的夏洛特医院，故事主角是美国人蒂莫西·雷·布朗。他自从2000年被查出感染艾滋病后，就一直在这里治疗。他的对手则是30年前被发现之后迅速肆虐全球，杀死了成百上千万病人的艾滋病。
在布朗治愈前，它已在他体内寄居了10年。在积极的治疗下，艾滋病毒并没有经常找布朗的麻烦。但不幸的是，布朗在几年之后又被查出患有急性髓性白血病，医生不得不为他进行骨髓移植。
艾克哈德·迪尔是布朗的主治医生。面对这个遭受两种绝症折磨的病人，他并没有轻易放弃，而是想通过一次骨髓移植同时解决这两大难题，实现一箭双雕。
在外人看来，一个同时患了艾滋病和白血病，半条腿已经伸进坟墓的人，能延长生命，已经是烧高香了，还想通过一次手术同时解决两大恶疾，简直就是做白日梦。但迪尔就是要让这个白日梦变为现实。
患白血病因祸得福的布朗
他的大胆尝试是源于上世纪90年代美国科学家的一项重要发现。“当时，在我们实验室有一位同事是同性恋，他在研究中发现有些人无论采用多么高危的行为，都不会感染艾滋病，后来找到了这些天生不感染艾滋病的人群的共性，是因为他们体内都存在一种基因缺陷。”清华大学艾滋病综合研究中心主任张林琦教授说，他当时正好在那个实验室。
张林琦教授介绍，艾滋病毒进入免疫系统，必须同时结合免疫细胞表面的两种物质CD4和CCR5，就像一把钥匙，必须同时具有两个孔，才能打开免疫细胞的大门。不感染艾滋病的人群幸运之处就是缺失CCR5基因。少了一个孔，钥匙自然无法打开大门。 缺失这种基因的人属北欧人居多，但也只占整个北欧人的8%。迪尔要做的，就是在所有适合为布朗的提供骨髓捐献的志愿者中，寻找一位正好缺失CCR5基因的人。其难度可想而知。
骨髓移植会首先破坏患者原有的免疫系统，然后建立和捐献骨髓者同样的免疫系统。也就是说，如果成功，捐献者体内的基因缺失就会通过骨髓移植，传递给布朗，让布朗治疗白血病的同时，也能将体内的艾滋病毒全部剿灭。或许是上天的眷顾，布朗非常幸运，在与他配型成功的60名骨髓捐献者中，就恰好有一位缺失CCR5基因的人！
2007年2月，布朗成功接受了骨髓移植手术。
奇迹一个接一个的诞生。迪尔医生的白日梦真的变成了现实：随着骨髓不断地造血，布朗的白血病逐渐康复，而且体内新生成的细胞具有令人兴奋的基因缺失！逐渐的，布朗体内的艾滋病病毒在慢慢地消失。
夏洛特医院的医生们非常谨慎。2009年，他们在全球顶级医学期刊《新英格兰医学》杂志上发表了一篇文章，很小心地把布朗的状况描述为“通过骨髓移植长期控制了艾滋病毒”。
此后，布朗接受了各种方法进行的HIV病毒检测，确定体内不再带有艾滋病毒，且身体恢复健康一年后，在全球顶级血液病杂志《血液》上，他们才正式宣称：艾滋病人布朗被治愈了！
作为6000多万艾滋病毒感染者和病人中的一员，布朗是第一位也是唯一一位被治愈的病人，他已成为全世界的明星病人。路透社在报道中写道，在这个“大家甚至不敢大声说‘治愈’这两个字的艾滋病领域里，这绝对是个振聋发聩的发现”。
布朗第二绝非易事
我能有幸成为第二个布朗吗？这是艾滋病人最关心的问题。
“‘布朗’还会出现，但绝非易事。”自从布朗闻名全球后，张林琦教授就不止一次地这么回答人们的提问，“因为他同时是一个白血病患者，这个不能传染，而且非常幸运地找到了对艾滋病毒有先天免疫力的骨髓捐献者，另外还要有足够的钱。”
这三条，缺一不可。张林琦教授认为，对于一个只感染了艾滋病，而没有白血病的患者进行骨髓移植治疗，几乎是可望而不可及。
因骨髓移植需要用药物摧毁人体原有的免疫系统，然后移植入捐献者的骨髓建立起新的免疫系统，这个过程本身就非常危险，而且存在不可预测的排异反应，在抗病毒治疗就能把艾滋病控制住的情况下，并不值得冒这么大风险。
即使忽略掉所有的风险，能不能找到合适的骨髓捐献者还是一个很大的问题。
在我国，缺失CCR5基因的人非常罕见。解放军传染病研究所所长王福生教授领衔的一项研究表明，中国人群CCR5基因平均突变率只有0.2%，而且主要存在于新疆的少数民族人群中。
布朗的出现是个个例，也仅仅是个特例，从现实考虑，布朗的奇迹很难复制。人们之所以对布朗如此关注，就是他让病人和医生看到了新的希望。
鸡尾酒疗法最为推崇
“艾滋病毒复制的精确度非常差，每次复制都会出现大量的‘错误’，准确性极低。”在清华大学艾滋病综合研究中心主任张林琦教授看来，这恰恰是病毒赖以生存的关键，因为你几乎找不到完全相同的两个艾滋病毒，就极大削弱了各种药物的作用。
美籍华裔科学家何大一在1996年提出了“鸡尾酒疗法”，通过联合应用3种或更多的抗逆转录病毒药物，遏制住对艾滋病毒的复制起关键作用的逆转录酶，同时针对病毒复制周期内的多个时间点展开治疗。坚持使用鸡尾酒疗法，艾滋病人可以重建其免疫功能，能像健康人一样长期生存。
美国最早接受鸡尾酒疗法的病人中，最出名的是篮球明星约翰逊，他在感染HIV近20年后的今天依然健在。2008年7月26日，《柳叶刀》杂志曾载文指出，鸡尾酒疗法自应用以来，HIV携带者和AIDS患者的预期寿命已平均延长13.8年，AIDS的死亡率则大幅下降近40%。所以目前鸡尾酒疗法仍是最为推崇的治疗方法之一。
而张林琦教授的实验室现在则设法通过基因技术，试图敲掉CCR5基因编码区域的第185号氨基酸的32碱基，但目前要想让这一一劳永逸的疗法成为主流，前面还有很长的路要走。
相关阅读
守好预防艾滋的三道屏障
中国疾控中心性病艾滋病预防控制中心主任吴尊友谈到布朗的时候说，我不要期盼成为布朗第二，而是不要成为“布朗”。
吴尊友告诉记者，艾滋病传染其实是通过被感染的细胞传染，单纯的病毒几乎不具备传染能力。如果身体皮肤、黏膜没有炎症，艾滋病毒即便进入身体，也会很快降解掉。怕就怕身体皮肤已出现了炎症或疾病，大大提高了艾滋病毒的传播可能性。
预防艾滋病，吴尊友建议人们谨慎守好三道屏障。
第一道屏障是安全套、杀微生物剂。安全套是很好的预防艾滋病的屏障，一对异性夫妻，一方是HIV感染者，一方是健康人，如果总是用安全套，十年感染的机会小于10%，不可能总用的话，传染的几率接近80%。坚持使用杀微生物剂也可以达到阻断病毒的效果。
第二道屏障是性病治疗。一个人如果得了性病，意味着他皮肤黏膜发生了炎症，病毒就能更容易穿过黏膜找到激活的CD4淋巴细胞，顺利进入体内并繁殖。
第三道屏障是高危行为的前、后预防。艾滋病在我国的传播现状已经由高危人群慢慢转向普通人群，主要原因就是越来越多的普通人没有意识到高危行为的危害性。如果能够预测到高危行为，最好提前服用抗病毒药物；如果已经发生了高危行为，短时间内服用抗病毒药物的阻断作用也非常明显。 （来源：健康时报）
艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复
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| 图示∶2011年5月正式出版的《中国特色医疗金鉴》登载的刘君主任及其机构事迹 |
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艾滋病新鸡尾酒疗法 附 HIV感染者，早吃药早受益
AIDS cure the world's first people: suffering from leukemia, a blessing in disguise (Figure)
At 11:12 on December 5, 2011 Source: People
Brown now know better how to enjoy life. People picture for map
Backgrounder: December 1, 2011 the world's first 24 "World AIDS Day" on the eve of more than 150 media editors and reporters gathered in Guangzhou, organized by the Press and Publication Administration held the third installment of the national print media AIDS prevention drug awareness training activities, the Secretary for Press and Publication Administration newspapers launched "National Press Tour drug prevention Yi Gongyi Advertise With special action" the same time.
Read the feed
- HIV in vivo has been housed at Brown ten years, or, worse, a few years later he was diagnosed with leukemia, his doctors had a bone marrow transplant, a bold attempt to double-edged sword Deere doctors cure AIDS and leukemia.
- HIV into the immune system, immune cells must be combined with the surface of the two substances CD4 and CCR5. Like a key, must also have two holes to open the door to immune cells. Fortunately, people are not infected with HIV is that it is missing the CCR5 gene.
- And Brown in the success of 60 matching bone marrow donor in the absence of CCR5 gene is just one person! Brown, through a successful bone marrow transplant to rebuild the immune system are also missing just CCR5 gene, to achieve the same cure leukemia, AIDS.
-2009, Brown's attending physician in the "New England Journal of Medicine" magazine published an article, the situation carefully to Brown described as "long-term control of bone marrow transplantation by HIV." Until one year after the "blood", they formally quite unashamedly declared: Brown has been cured of AIDS!
- The second Brown will emerge? Tsinghua University Professor Zhang Linqi the answer is "'Brown' will appear, but will not be easy." Because Brown is also a leukemia patient, and very fortunate to find innate immunity to HIV have bone marrow donors, in addition to have enough money.
AIDS has been cured, but to eradicate, and the body has been without HIV it!
This lucky guy is a 43-year-old American - Brown, Germany, in December last year cured. Even more funny is that he's the reason why AIDS can be cured, in fact, a blessing in disguise, because he suffered from fatal leukemia.
Indeed, this story sounds like a made up fictional screenplay, but the top international medical journal "Blood" magazine tell the world: This is a true case.
Daydream doctors should achieve
Miracle took place in Berlin, Germany, Charlotte hospital, the story the protagonist is an American Timothy Xilei Brown. Since 2000, he was found infected with AIDS, it has been treated here. His opponent is 30 years ago, soon after the outbreak was discovered the world, killing millions of AIDS patients.
Brown to cure before it is housed in his body for 10 years. In the active treatment, HIV does not always find Brown's trouble. Unfortunately, Brown a few years later was diagnosed with acute myeloid leukemia, the doctor had his bone marrow transplant.
Eckhard Deere Brown's doctor. Faced with this being two kinds of patients terminally ill tortured, he did not give up easily, but want a bone marrow transplant while addressing these two problems, to achieve double-edged sword.
To outsiders, a the same time suffering from AIDS and leukemia, and a half into his grave human leg has been able to prolong life, is burned incense, want to solve through a surgery while the two disease that simply do day a dream. But Deere is to make this fantasy a reality.
Brown leukemia blessing in disguise
His bold attempt from the 1990s American scientists is an important discovery. "At that time, a colleague in our lab is gay, his research found that some people no matter how high-risk behavior, are not infected with HIV, and later found infected with HIV in these natural populations are not common, because their bodies there is a genetic defect. "Tsinghua Comprehensive AIDS Research Center, Professor Zhang Linqi, said he was just in that laboratory.
Professor Zhang Linqi introduction of HIV into the immune system, immune cells must be combined with the surface of the two substances CD4 and CCR5, as a key, must have two holes to open the door to immune cells. Fortunately, people are not infected with HIV is that it is missing the CCR5 gene. One less hole, the natural key can not open the door. People who lack this gene are mostly Scandinavians, but only 8% of the Nordic people. Deere to do is fit in all of Brown's volunteers donated bone marrow to find a person who just lack the CCR5 gene. Its difficult to imagine.
Bone marrow transplant patients will first destroy the old immune system, and then build and donate bone marrow were the same immune system. That is, if successful, the body of the donor bone marrow transplantation by gene deletion will be passed to Brown, so Brown's treatment of leukemia, but also can destroy the body of all HIV. Perhaps God's blessing, Brown is very fortunate with the success of his 60 matching bone marrow donor in the absence of CCR5 gene is just one person!
In February 2007, Brown received a successful bone marrow transplant.
One after the birth of a miracle. Dr. Deere's daydream really become a reality: With the bone marrow constantly, gradually recovered Brown's leukemia, and the newly generated cells in vivo exciting gene deletion! Gradually, Brown HIV in the body slowly disappear.
Charlotte doctors are very cautious. In 2009, they are the world's top medical journals in the "New England Journal of Medicine" magazine published an article, the situation carefully to Brown described as "long-term control of bone marrow transplantation by HIV."
Since then, Brown received a variety of methods of HIV testing, to determine the body is no longer with HIV, and the body to restore health after one year, blood diseases in the world's top magazine "blood", they formally declared: AIDS Brown was cured!
As more than 60 million HIV infected people and patients, a member of Brown was the first and only one patient was cured, he has become the world's star patients. Reuters wrote in its report, in this "we even dare to say out loud 'cure' the word of the AIDS field, this is definitely enlightening discoveries."
Brown, the second is not easy
I am lucky enough to become the second Brown do? This is most concerned about AIDS.
"'Brown' will appear, but will not be easy." After the world famous since Brown, Professor Zhang Linqi so on more than once to answer people's questions, "because he is a leukemia patient, this can not be transmitted, and very fortunate to HIV has found a bone marrow donor innate immunity, in addition to also have enough money. "
These three are indispensable. Professor Zhang Linqi that only infected with HIV for a while without a bone marrow transplant patients with leukemia treatment, almost elusive.
Need for bone marrow transplant drugs to destroy the original body's immune system, and then transplanted into the donor's bone marrow to establish a new immune system, the process itself is very dangerous, unpredictable and there is rejection in anti-viral treatment can control of AIDS cases is not worth taking such a big risk.
Even ignoring all the risks, can not find a suitable bone marrow donor is still a big problem.
In China, the lack of CCR5 gene are very rare. People's Liberation Army led by Professor Wang Fusheng Institute of Infectious Diseases, a study showed that CCR5 gene in Chinese population average mutation rate of only 0.2%, but mainly in the Xinjiang ethnic minority populations.
Brown is the emergence of all cases, it is only a special case, from practical considerations, Brown's miracle hard to replicate. The reason why Brown is so concerned about people, so that patients and doctors that he saw new hope.
Cocktail of the most respected
"HIV replication accuracy is very poor, each copy will be a large number of 'errors', accuracy is very low." AIDS Research Center at Tsinghua University Director Professor Zhang Linqi view, this is precisely the key to the survival of the virus, Because you almost can not find two identical HIV, it greatly weakened the role of various drugs.
Chinese-American scientist David Ho in 1996, proposed a "cocktail therapy", through the combination of three or more antiretroviral drugs to contain the replication of HIV reverse transcriptase play a key role, while for the virus replication cycle, the more time to start treatment. Stick with HAART, AIDS can rebuild its immune function, as long as healthy people can survive.
The earliest American patients receiving HAART, the most famous basketball star Johnson, in his nearly 20 years after HIV infection is still alive today. July 26, 2008, "Lancet" magazine had carried an article that has been applied since HAART, HIV carriers and AIDS patients to extend the life expectancy of 13.8 years on average, AIDS mortality has dropped by nearly 40% is substantial. Therefore, the current cocktail is still one of the most respected treatment.
And Professor Zhang Linqi laboratory now managed by gene technology, trying to knock the CCR5 gene coding region of the first 185 amino acids of the 32 bases, but to get this once and for all the therapy into the mainstream, there's still a long way to go.
Related reading
Keep a good barrier to prevent HIV in three
STD and AIDS Control and Prevention, China CDC director Wu Zunyou Brown, when he talked about, I do not expect Brown to become the second, but do not become "Brown."
Wu Zunyou told reporters that AIDS infection is transmitted by infected cells, simply do not have the transmission capacity of the virus almost. If the body skin, mucous membranes without inflammation, even if HIV enters the body, degradation will soon fall. Afraid afraid of the body skin inflammation or disease has emerged, greatly increased the likelihood of HIV transmission.
AIDS prevention, Wu Zunyou recommend that people carefully observe good three barriers.
The first barrier is a condom, microbicides. Condoms to prevent AIDS is a good barrier, a pair of heterosexual couples, one is HIV-infected persons, one is healthy, if you always use condoms, ten years less than 10% chance of infection, not always with the words, infection probability close to 80%. Insist on using microbicides can achieve the effect of blocking the virus.
The second barrier is a venereal disease treatment. If a person had sexually transmitted diseases, means that he had inflammation of the skin and mucosa, the virus can be found more easily through the activation of mucosal CD4 lymphocytes, smooth entry into the body and reproduction.
The third barrier is the high-risk behavior before and after prevention. The spread of HIV status in China has gradually shifted from the general population at high risk, mainly because more and more ordinary people do not realize the dangers of high-risk behavior. If you can predict high-risk behavior, it is preferable to take antiviral drugs; if high-risk behavior has occurred, a short time to take antiviral drugs blocking effect is very obvious. (Source: Health Times)
