《新英格蘭醫(yī)學(xué)雜志》最新刊登一篇專題文章，介紹一位美國(guó)的HIV攜帶患者，在德國(guó)通過(guò)骨髓移植手術(shù)，不僅擺脫了終生服藥，同時(shí)也沒(méi)有復(fù)發(fā)。
這一病例的成功為HIV的基因治療帶來(lái)了新希望。以往患者必須通過(guò)長(zhǎng)時(shí)間服用昂貴的藥物才能控制病情。以這位接受手術(shù)的美國(guó)患者為例，他被診斷HIV陽(yáng)性已經(jīng)有十年，之前他一直靠抗后病毒藥物治療，但之后他的病情發(fā)展到白血病。于是，當(dāng)他住進(jìn)柏林的醫(yī)院后，主治醫(yī)生Hutter博士為他制定的針對(duì)性的治療計(jì)劃。
醫(yī)生為他特別尋找了體內(nèi)具有HIV抗體的骨髓捐助者。醫(yī)學(xué)研究者發(fā)現(xiàn)，有一些人體內(nèi)天生就帶有HIV抗體，在西方人中，約有1%-3%的人具有這種特質(zhì)。在完成骨髓移植手術(shù)二年后，這位病人不僅不必再服用藥物治療，之前的白血病也消失了，造血機(jī)能得以恢復(fù)。
目前在歐洲，一般的HIV平均治療費(fèi)用是每年七萬(wàn)至八萬(wàn)歐元，而一次性的骨髓移植手術(shù)只需要花費(fèi)兩萬(wàn)歐元。Hutter博士表示，也并不是每個(gè)人都適合骨髓移值，因?yàn)檎业胶线m的骨髓捐助人非常不容易。但如果將這種療法稍加修改，通過(guò)基因療法，研究出HIV的抗體，是完全可能的。這無(wú)疑為醫(yī)學(xué)界打開(kāi)了一扇新窗。
GENE THERAPY OFFERS HOPE OF CURE FOR HIV
Doctors have succeeded in ridding a man of the HIV virus by giving him a bone marrow transplant in what they claim is the closest treatment yet to a cure for the disease.
The remarkable case gives new impetus to the development of gene therapy for HIV which could ultimately replace the need for expensive and toxic antiretroviral drugs. Instead of taking drugs for life, HIV sufferers might instead have a one-off treatment that would leave them virus-free.
The 42-year-old American had been infected with HIV for a decade. He was treated with antiretroviral drugs in Berlin, where he lives, for four years to hold the disease in check, but then developed leukaemia. Since being given a bone marrow transplant two years ago, he has not taken antiretroviral drugs to control HIV and has had no resurgence of either disease. He is believed to be the longest HIV-free survivor who was previously treated with antiretroviral drugs. Full details of the case are published for the first time today in The New England Journal of Medicine.
Dr Hutter said a bone marrow transplant would be too risky as a routine treatment for HIV and too difficult to find donors with the right genetic make-up. But a modification of the approach using gene therapy to render a patient HIV-resistant could work, he said.
Even a costly treatment could be worthwhile. The price of treatment with antiretrovirals in Europe is €70,000 to €80,000 (￡63,000 to ￡72,000) a year compared with a one-off cost of €20,000 to €30,000 for a bone marrow transplant.
Dr Hutter said: "When I started in medicine, HIV was completely untreatable. Now the situation has changed completely. Perhaps our case is a glimpse of hope for the future."
（Source: Indepedent，英國(guó)使館文化教育處提供）
