日前，一则艾滋病可以吃药预防的消息引发社会高度关注。消息称，当地时间7月16日，美国食品与药物管理局(FDA)批准使用特鲁瓦达(Truvada)，该药是全球首个艾滋病预防药。据称，按医嘱定量服用该药后，感染艾滋病病毒机会可下降42%。有制药商甚至声称“已经能够看到艾滋病的终结”。

a，An AIDS prevention medicine can lead to social news of the high attention。News says，The local time on July 16，The us food and drug administration(FDA)Use trudi watts of approval(Truvada)，The drug is the world's first AIDS prevention medicine。allegedly，The orders after taking the quantitative，The AIDS virus opportunity can reduce 42%。A drug manufacturer even claim“Has to be able to see the end of AIDS”。

　　特鲁瓦达能否成为艾滋病的“终结者”？是否可取代基本的预防艾滋病手段？我国有无可能批准使用预防艾滋病类药物？

Trudi watts of can become AIDS“terminator”？Whether can replace primary prevention AIDS means？China may have approved HIV/AIDS drugs to use？

　　昨天，本报对话中国疾病预防控制中心艾滋病首席专家邵一鸣。

yesterday，This dialogue China centers for disease control and prevention chief expert ShaoYiMing HIV/AIDS。

　　

谈药品效果 Talk about drug effect

　　“使用药物最主要的目的是治疗，药物预防只是众多手段中的一种。抗击艾滋病任何一种单一的措施都不是万能的，必须通过综合预防和治疗措施。”

“The use of drugs to be the main goal is the treatment，Drug prevention is just one of the many means。Fighting AIDS any individual measures are not everything，Must through the comprehensive prevention and treatment measures。”

　　京华时报：全球首个艾滋病预防药是什么概念？是第一个成功研制的，还是说有很多成功研制的，但这是第一个被国家官方批准的？

Jinghua times：The world's first AIDS prevention medicine is what concept？Is the first successful development，Or say many successful development，But this is the first national official approval？

　　邵一鸣：其实这个药是两种治疗用药的合剂。药品用于治疗是早就有的，用于预防是新批准的。一般来说药物都是得了病以后去治疗，用治疗的药物去预防并不常见。按照以往的病例，比如疟疾，人要是到了疟疾的流行区去工作、旅行，可以吃点治疗疟疾的药，用于预防。但这是短时间的，离开这一区域就不用吃了。长期使用一种药物预防传染病的比较少。这可以说是特定的治疗药物用于预防的特殊例子。

ShaoYiMing：Actually this medicine is two kinds of drugs to treat mixture。Drug used to treat had some，Used for prevention is newly approved。Generally speaking drugs have been ill for after treatment，Use of the drug to prevent treatment is not common。According to the past cases，Such as malaria，People if the malaria popular area to work、travel，Can eat malaria drugs，Used to prevent。But this is a short，Leave the area need not eat。Long-term use of a drug to prevent infectious disease less。This can be said to be specific drug treatment used to prevent the special case。

　　京华时报：原来为什么没有用于预防？

Jinghua times：Why didn't originally used to prevent？

　　邵一鸣：从理论上来讲,大家都知道治疗性的药物可能有预防的作用。但是需要大规模的临床试验来验证。现在使用这种药物试验结果已经出来了。通过严格的科学研究证实了预防效果。所以美国FDA首次批准了一个合剂用于没有感染HIV的健康人。

ShaoYiMing：theoretically,We all know that therapeutic drugs may have preventive role。But need to large-scale clinical trials to test。Now use this drug test results had come out。Through the strict scientific study confirmed preventive effect。So the FDA approval for the first time a mixture is used for healthy not infected with HIV。

　　京华时报：制药商说已经能够看到艾滋病的终结，如何评价这种观点？

Jinghua times：Drug makers said the end of AIDS has been able to see，How to evaluate this point of view？

　　邵一鸣：艾滋病发现已经30多年了，蔓延全球各个角落，使用药物最主要的目的是治疗，药物预防只能说是众多手段中的一种。过去30多年总结的最主要的经验是，抗击艾滋病任何一种单一的措施都不是万能的，必须通过综合预防和治疗措施。现在可能预防效果能达到四成、五成，即便达到六成、乃至七成，距离艾滋病完全控制还是有很大差距。因此这种说法是过于乐观和过于幼稚的。希望不是出于商业考虑。

ShaoYiMing：AIDS has found that more than 30 years，Spread all corners of the earth，The use of drugs to be the main goal is the treatment，Drug prevention can only say that one of the means of many。Over the past 30 years of summary of the main experience is，Fighting AIDS any individual measures are not everything，Must through the comprehensive prevention and treatment measures。Now may prevent the effect can reach forty percent、Fifty percent，Even at sixty percent、And even seventy percent，Distance full control of AIDS or had the very big disparity。So this kind of view is too optimistic and too naive。Hope is not out of business consideration。

　

　谈药品使用 Talk about drug use

　　“关键是高危人群能否按时按量长期坚持服药。不好好服药不但预防效果会大打折扣,一旦被HIV感染后还很容易产生抗药的病毒。”

“The key is whether each high-risk groups on time insist for a long time to take medication。Not good medicine not only prevent the effect will be to sell at a discount greatly,Once HIV infection is very easy to produce after drug resistance of the virus。”

　　京华时报：这种药对人体有没有副作用？在社会层面来说有何影响？

Jinghua times：This medicine have side effect to human body？In the society level what effect it？

　　邵一鸣：中国老话说的是药三分毒,用药治病是可承担的风险,但将药给健康人用于防病,药监部门需要更长时间仔细权衡药物毒副作用与防病作用之间的利弊。由于预防艾滋病太难,所以批准用药预防,两害相权取其轻。这也是你先前问的原来为什么没用于预防的另一个原因。还有一个重要问题是,这种预防效果是短期的还是长期的？严格监督的临床试验有效,在大规模公共卫生模式下是否也有效？这有待于在未来防治工作中检验。关键是高危人群能否按时按量长期坚持服药。不好好服药不但预防效果会大打折扣,一旦被HIV感染后还很容易产生抗药的病毒。

ShaoYiMing：China is the old saying goes medicine 3 minutes poison,Medicine cure is of the risks,But will medicine healthy person used for diseases,The drug agency need longer time to carefully weigh the drug toxicity and disease prevention between the advantages and disadvantages of the role。Due to prevent AIDS too difficult,So approved drug prevention,Of two evils choose the light。This is your previous asked why didn't the original used to prevent another reason。There is an important problem is,This kind of preventive effect is short-term or long-term？Strict supervision of clinical trials effective,In large-scale public health mode is also effective？This needs to be in the future in the prevention and control of inspection。The key is whether each high-risk groups on time insist for a long time to take medication。Not good medicine not only prevent the effect will be to sell at a discount greatly,Once HIV infection is very easy to produce after drug resistance of the virus。

　　京华时报：这意味着什么？

Jinghua times：What this means？

　　邵一鸣：尤其是某些高危行为人群，比如吸毒人群，对毒品高度依赖的人，工作、家庭等等对他们来说都已经不重要了，更何况服药？如果这类人群没有按要求按时按顿服药，有时候吃，有时候不吃，一旦感染很容易出现耐药病毒的情况,大大增加自己和传播给其他人的治疗难度。

ShaoYiMing：Especially some high-risk behavior the crowd，Such as drug users，To drugs is highly dependent on the man，work、The family, and so on for them are not important，Besides medication？If such people do not on time according to the requirements for according to the medicine，Sometimes eat，Sometimes don't eat，Once infected very prone to resistance of the virus,Greatly increase his and spread to others treatment difficulty。

　　京华时报：针对服用了这种药，但没有按要求服用而感染艾滋病的，有治疗方案吗？

Jinghua times：Take this medicine for，But without taking and according to the requirements of HIV，A treatment program？

　　邵一鸣：他就不应该再服用这种药，而要立即改换适当的三联合剂来治疗艾滋病。但他的治疗成本将大大增加，治疗的效果也将大打折扣。

ShaoYiMing：He should stop taking the medicine，And immediately change the appropriate sanlian mixture to treat AIDS。But his treatment costs will increase greatly，The effects of the treatment will also sell at a discount greatly。

　　

谈防治手段 Talk about prevention and control means

　　“在用药同时，也希望能带动高危人群对生命的关注，改变行为方式。使用药物预防实际上是预防的最后一道防线，是不得已的方式。”

“In drug use and，Also hope to be able to drive the high-risk groups to the life the attention，Change behavior。The use of drugs to prevent is actually prevent last line of defense，The way is necessary。”

　　京华时报：我国在预防艾滋病药物方面的研究情况是怎样的？

Jinghua times：Our country in the prevention of AIDS drugs in the research of the situation is what kind of？

　　邵一鸣：这种药我们国家还没有。但是相关的研究是有的。我国“十一五”重大专项安排了暴露前预防用药的研究,由重庆、广西和新疆三所医科大学用药物预防艾滋病的可行性研究，目前正在启动“十二五”将全面应用于艾滋病的预防的研究。

ShaoYiMing：This medicine we countries are not。But the related research is there。Our country“11”Major special arrangement of exposure to the prevention of drug use before,The chongqing、Guangxi and xinjiang three YiKeDa learning to the drug prevention feasibility study，At present is starting“1025”Will be fully applied to AIDS prevention research。

　　京华时报：您对国家层面批准使用预防艾滋病类药物怎么看？如果中国引进这种药物您怎么看？

Jinghua times：You use to the national level approved HIV/AIDS drugs how to see？If China to introduce this drug, what do you see？

　　邵一鸣：正因为刚才提到，抗击艾滋病任何一种单一的措施都不是万能的。因此多一个措施总比少一个措施好。但是从一个国家的战略角度讲，我个人也不建议采用单一的药物预防的方式抗击艾滋病。我们国家不仅有艾滋病患者，还是肝炎大国，还有很多其他的疾病也需要国家预防和治疗，不能为单独一个病种使用无限多的资源。无论是发达国家还是发展中国家都应该建立综合预防体系。

ShaoYiMing：Because just mentioned，Fighting AIDS any individual measures are not everything。So one more measures less than a total measures。But from a national strategic Angle，I also don't suggest USES a single drug prevention way to fight AIDS。Our country has not only those with HIV/AIDS，Or hepatitis powers，There are many other disease also need national prevention and treatment，Not for a single disease to use unlimited resources。Both developed and developing countries should establish comprehensive prevention system。

　　京华时报：您提到资源，目前我国艾滋病防治方面资源情况如何？

Jinghua times：You mentioned that resources，At present our country AIDS prevention and resources condition？

　　邵一鸣：我们常说艾滋病预防和治疗，目前全球包括我们国家仅仅在治疗方面，仅仅在一部分患者而非全部患者得到治疗的情况下，仅药品和相关检测的资源的使用已经占据社会预防艾滋病资源的三分之二以上。要知道，预防也是非常重要的啊。所以我们必须强调，综合措施防治艾滋病。如果国家层面主推药物预防，一方面我们在扩大治疗人群，另一方面没有感染的人也要用药物预防，现有防治艾滋病的经费的全部再增加五倍都不够，这会使我们陷入完全不可持续的防治境地。此外，刚才提到耐药性问题，如果单纯依靠药物预防，这些人群必须定期做检查，看看到底预防有没有成功，不成功赶快换药。这也将产生巨大的操作成本。

ShaoYiMing：We often say that AIDS prevention and treatment，At present our country in the world including the only treatment，Only in the part of the patient and not all patients get treatment，Drug and related inspection of only the use of resources have dominated society more than two-thirds of AIDS prevention resources。Want to know，Prevention is also very important to me。So we must emphasize，Comprehensive prevention and control measures of AIDS。If the national level main drug prevention，On one hand, we expand treatment in the crowd，On the other hand not infected person to also want to use drug prevention，The existing funds for prevention and treatment of HIV/AIDS all add five times are not enough，This will make us completely unsustainable in the prevention and control of the situation。In addition，Just mentioned resistance problem，If rely solely on drug prevention，These people must periodically do check，See how to prevent any success，Don't succeed quickly change medicine。This will also produce the huge operating costs。

　　京华时报：您说的综合预防措施具体指什么？

Jinghua times：You said, the comprehensive prevention measures refer to？

　　邵一鸣：当然药物预防算一种，同时还有更便宜也更有效的基本的预防手段。比如改变高危行为、使用安全套、吸毒人员一时戒不了要注意安全注射等。但正是因为这些更便宜、更有效的方式不被采用，所以人们才研制了这样的药物。反过来在使用药物的时候，也希望能够带动高危人群对生命的关注，改变行为方式。使用药物预防实际上是预防的最后一道防线，是不得已的方式。

ShaoYiMing：Of course is a kind of drug prevention，At the same time there are cheaper and more effective basic preventive measures。Such as the change of high-risk behavior、The use of condoms、A addicts can't stop to pay attention to safety injection, etc。But it is the cheaper、A more effective way not used，So people just developed such drug。In the use of the drug，Also hope to be able to drive the high-risk groups to the life the attention，Change behavior。The use of drugs to prevent is actually prevent last line of defense，The way is necessary。

　

　-人物 -character

　　邵一鸣

ShaoYiMing

　　现任中国疾病预防控制中心艾滋病首席专家，性病艾滋病预防控制中心病毒与免疫研究室主任,中国艾滋病疫苗联盟(CAVI)发起人之一。获中国预防医科院博士学位。曾留学法德两国，1989年任世界卫生组织总部全球艾滋病规划顾问，1990年回国，参加艾滋病防治和科研工作至今。曾任卫生部艾滋病预防控制中心副主任，国家参比实验室主任。

The centers for disease control and prevention of the China AIDS chief expert，Venereal disease AIDS prevention and control center virus and immune director of research,China AIDS vaccine alliance(CAVI)One of the sponsors。To prevent YiKeYuan doctor degree in China。France and Germany, the two countries have study abroad，1989 years RenShiJie health organization headquarters global AIDS planning consultant，Returning to China in 1990，To participate in HIV/AIDS prevention and control and the scientific research work today。The health ministry served as deputy director of the AIDS prevention and control center，CST laboratory of the country。

　　-关键词

-key words

　　特鲁瓦达(Truvada)

Trudi watts of(Truvada)

　　是一种抗逆转录病毒药，主要成分为恩去他滨和提诺福韦，主要用于治疗艾滋病病毒感染。自2010年开始，有报告认为特鲁瓦达可作为男性预防艾滋病病毒感染的药物，而被一些倡导组织提议作为艾滋病疫苗的替代品。2012年5月10日，美国食品与药物管理局(FDA)联邦顾问小组对是否批准特鲁瓦达面世召开研讨会，投票最终结果在6月15日公布。7月16日，美国食品与药物管理局批准使用特鲁瓦达作为预防感染艾滋病病毒的药物。

Is a kind of antiretroviral drugs，The main composition is well to shore and ask him maybe tenofovir，Mainly used in the treatment of AIDS virus infection。Since 2010，A report that trudi watts as men to prevent infected with the virus that causes AIDS drugs，Some advocacy group was proposed as a substitute for the AIDS vaccine。May 10, 2012，The us food and drug administration(FDA)The federal advisory panel on whether to approve trudi watts available to a conference，Final results in the vote on June 15, published。July 16,，The us food and drug administration approved use trudi watts of as prevent infected with the virus that causes AIDS drugs。

　　本版采写本报记者张然本报漫画谢瑶

Benban up to date ZhangRan our newspaper cartoons XieYao our reporter