美国心态诊疗中心制作的海报。海报上的孩子张开双臂呼唤：“我有艾滋病，但请抱抱我，这样不会传染给你。”
下次安慰艾滋病患者时，“别哭”可能另有含义。近日，北京协和医院感染内科主任李太生研究发现，经过治疗、血液中艾滋病病毒已呈阴性的艾滋病患者的眼泪中，依然含有艾滋病病毒。这一研究成果发表在9月份的国际学术期刊《艾滋病》上。
这条消息引起人们对“世纪杀手”的新一轮恐慌，“看来眼泪也能传染艾滋病了，人类当真不能阻挡艾滋病病毒了？”
对此，李太生在接受中国青年报采访时纠正说，自己的研究并不能得出“眼泪是艾滋病的第四种传播途径”的结论，只能推测泪腺和泪液等成为艾滋病病毒的新“据点”。
藏在角落的病毒贼窝，亮起了灯
当2011年9月16日下班时间到来时，47岁的李太生还在协和医院东配楼的办公室里忙碌着。办公室的三面墙都是书柜，摆放着关于艾滋病研究报告的文件夹、艾滋病研究的学术期刊和专业书籍，以及他因艾滋病研究的突破性进展而获得的荣誉奖杯。
这位发表过200多篇学术论文、跟艾滋病病毒打了20多年交道的医生聊起最新发现，一脸认真：“我们在长期接受鸡尾酒疗法治疗的患者眼泪里发现了大量艾滋病病毒，这里是病毒的新‘据点’。”
尽管早在1985年，研究人员就在艾滋病患者的眼泪里检测出了病毒，但李太生研究证明，即便患者接受了长期治疗，眼泪中依然存活着艾滋病病毒，甚至和尚未接受治疗时数量相当。
“这就好像在屋子里抓蚊子，当你拿杀虫剂杀死了大部分蚊子以后，却发现角落里还躲着不少蚊子。”李太生说。
在身体这所大房间里，艾滋病病毒就像黑暗中的蚊子。它们叮咬健康细胞，将其感染后快速复制、感染更多的细胞，最终摧毁人体免疫系统。房间变得摇摇欲坠，患者感染其他疾病，最终死亡。
正是因为这种超强复制力和攻击力，这种全名为“获得性免疫缺陷综合征”的疾病成为人们闻之色变的“史后世纪的瘟疫”。
不过，“蚊子”也有不同类型：一种非常活跃，在房间里飞来飞去；另一种默默躲在角落，进行着低水平的复制活动。
在清华大学艾滋病综合研究中心教授张林琦的描述里，全球的研究人员都在为对抗“蚊子”绞尽脑汁。他们的作战计划很明确——首先用药物有效地控制病毒发作，消灭可以看得见的敌人；杀死活跃分子之后，再控制负隅顽抗的病毒，不让它们冒出来，然后将其消灭。
第一个作战计划正在颇有成效地进行。尤其是1996年鸡尾酒疗法提出后，这种有如高效杀虫剂的治疗方法，能够有效控制大部分活跃的艾滋病病毒。数据显示，患者在接受治疗3～6个月后，血液里的病毒就大幅减少。
不过，第二个作战计划就让医生们犯了难。躲在角落里的病毒在治疗的对抗中得以苟活。它们虽然暂时不活跃，可一旦对抗病毒的药物消失，就马上恢复攻击本质。更要命的是，它们躲在暗处，谁也不知道它们身处何方。
李太生举例说，曾有一位患者在坚持了3年的治疗后，血浆中已经没有艾滋病病毒。但是当患者不愿意继续服药、停药3个月后，“病毒全部复活”。
在医学术语里，这些藏匿不活跃艾滋病病毒的角落叫做病毒储存库。在此之前，人们知道的储存库主要指静止状态的细胞，包括脑细胞、血液里的淋巴细胞、脑积液等等。
现在，一个新窝点被挖了出来，那就是眼泪。
“当血浆里的病毒得到控制的时候，眼泪里的病毒却依然存在，这说明还有些地方在向身体释放艾滋病病毒。如果能够继续将释放病毒的源头找到，将是很有意义的发现。”张林琦认为，如果李太生的实验能够进一步得到证实，将为今后的艾滋病治疗提供新的研究方向。
这次发现的最大意义也在于此——想要抓贼，要先找到贼窝，房间里又有一个角落亮起了灯。
让哭泣的艾滋病人笑着走出门
这场关于眼泪的研究，其实起源于一次误会。
2005年，李太生治疗的一位艾滋病患者因患有白内障做了眼部手术。他在检查患者眼球内的房水后发现，里面存在大量艾滋病病毒。
李太生将发现公布于众，却被不明就里的记者写成了 “专家称，眼泪里有艾滋病病毒”！
事实上，房水和眼泪是两回事。房水是在眼球内部、充满眼球前房和后房的透明液体，一般情况下人们根本无法接触到。
看到媒体的误读，李太生本想站出来澄清，却犹豫了起来：“我的实验只能证明房水里含有病毒，但是眼泪里到底有没有，我没做过实验，没法下结论。”
从2006年开始，他领导着其他8个人开始了对艾滋病患者眼泪的研究。他们找到了21位患者，其中研究组包括16位长期接受鸡尾酒疗法的患者，他们的外周血艾滋病病毒已经呈阴性，此外还选择了2名新诊断患者、3名治疗后产生耐药的患者作为对照组。
实验在北京协和医院艾滋病诊疗中心进行。志愿提供眼泪的患者会在就诊后来到这个房间，为实验提供眼泪。
虽然每人只需要1毫升泪水，但实验对这约合20滴泪水要求严格——收集的眼泪要保证不被污染，收集成功后在低温中保存。
最大的困难在于如何让患者掉泪。“并不是每个人都像演员一样很快就能泪流满面，我们得想办法营造出一个适宜流泪的气氛。”负责收集眼泪的专职护士李雁凌说。
一般情况下，李雁凌和助手会在办公室里播放《二泉映月》等比较悲伤的音乐，然后坐下来聊天。
“有一个打工妹，在汶川地震后很热心地去献血，却在检查中发现自己患有艾滋病。她的身世很坎坷，5岁的时候妈妈就去世了，父亲对她也不好，好不容易找到一个疼她的男朋友，又不幸去世了，这个女孩不知道，他是艾滋病患者。”
李雁凌曾用这个故事打动患者流下眼泪：“也许是同病相怜，患者比较容易为跟自己处境相似的人流泪。”
不过，需要这么大费周章流眼泪的人并不多。“80%的病人取眼泪很容易，有的人眼泪比较多，打个哈欠就差不多够了。也有人特别容易感动，有时候根本不需要我来讲故事，他们自己会说起一些伤心的事情，说得我也忍不住跟着一起掉眼泪。”李雁凌说。
当眼泪即将夺眶而出时，李雁凌和助手用微量移液器取出眼泪。这个仪器就像是一支笔，前端装有一个吸头，通过控制按钮将眼泪吸入。整个过程大约需要15～20分钟。
但李雁凌还会继续和患者聊天。他们聊聊“最近找到的新工作”、“马上就要上高中的孩子”以及患者积极的治疗结果，用笑容来结束眼泪的收集实验。
拿到眼泪样本后，李太生的团队开始在实验室加紧检测。结果显示，经过长期治疗的患者眼泪里的病毒数量，和刚刚确诊艾滋病的人的对照，相差并不大。
对这一结论，实验小组不敢掉以轻心。他们使用了3种不同的实验方法，研究了5年，但是不管是对治疗3个月的新病人，还是治疗3年的老患者，结论都是一样。在反复推敲后，李太生和同事们才将发现正式公布。
他们发布在《艾滋病》期刊上的论文这样写道：“我们有证据证明，当血液的病毒得到抑制的时候，眼泪里依然存在大量病毒，眼泪应是艾滋病病毒的储存库。”论文还对临床提供了指导意见，“在对艾滋病病毒阳性患者进行眼部检查或手术时，要加强防护、谨慎处理”。
到目前为止，全世界没有一例病例是因为接触眼泪染病的
但是，这一次人们好像又误读了意思。用“艾滋病”“眼泪”做关键词搜索，得到的结论前几页多是“眼泪可能成艾滋病传播新途径”，这让李太生看得直摇头。
“我们证明了眼泪里含有病毒，但并不代表病毒一定会通过这种方式传播。”李太生说，“到目前为止，全世界还没有一例病例是因为接触眼泪染病的。”
事实上，艾滋病的主要传播途径依然是血液传播、母婴传播和性传播。卫生部2010年统计数据显示，性传播已成为我国艾滋病主要传播途径。截至2010年10月底，我国累计报告艾滋病病毒感染者和病人37万余例，其中病人13万余例，死亡6.8万余例。
目前，医学界还没有找到根治艾滋病的方法，但已经掌握了从死神手里抢夺时间的本领。在鸡尾酒疗法的治疗下，艾滋病已经可以像高血压、糖尿病一样得以控制。目前，抗病毒治疗可以延长病人寿命30年～50年，比完全治愈的预期寿命只提前10年。一个例子就是美国篮球明星约翰逊。他从上世纪90年代开始接受治疗，今天依然健在。
另一个消息是，预防艾滋病也许指日可待了。今年9月12日在泰国曼谷举行的世界艾滋病疫苗大会上的一些新消息，令跟艾滋病作战了20多年的张林琦颇为兴奋。在这次会议上，科学家们讨论起目前研制的疫苗的试验效果，以及未来5年疫苗研制方向等话题。
“关于疫苗研制的最大亮点是，在1.6万名临床试验受试者身上，我们发现了有些保护性和免疫指标是相关的。这就为我们下一步疫苗的设计提供了线索。”张林琦说。
这次发现也许可以帮助人类找到瞄准一个集中的确定目标研发疫苗，一发即中，将艾滋病病毒扼杀在萌芽期。相比于绞尽脑汁琢磨怎么消灭潜入房间、躲在暗处的蚊子，也许从一开始就给蚊子会溜进来的地方加一层纱窗更为有效。
与此同时，李太生继续为“阻挡艾滋病病毒”而忙碌。对着电脑屏幕上满是误解的报道，李太生计划着把英文论文翻译成汉语发表在中文学术期刊上，在人们对艾滋病还怀有恐惧的情况下，“至少可以减少对它的误读”。
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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AIDS, do not cry!
http://www.sina.com.cn 2011 年 09 月 21 日 05:35 China Youth Daily
American mentality clinics posters. Posters calling on the children with open arms: "I have AIDS, please hug me, this will not infect you."
Next to comfort AIDS patients, the "cry" may be another meaning. Recently, the Beijing Union Medical College Hospital medical director Li Taisheng study found that after treatment, the blood of HIV-negative AIDS patients has shown a tear, still contain HIV virus. The study, published in September, an international academic journal "AIDS" on.
This message is to draw attention to the "Century killer" of a new round of panic, "It seems that tears can also be transmitted HIV, the human AIDS virus really can not stop it?"
In this regard, Li Taisheng In an interview with China Youth Daily interview to correct that their study does not produce the "tears of a fourth route of transmission of AIDS," the conclusion can only be speculated that the lacrimal gland and tear such as HIV new "base" .
The virus hidden in the corner of the den of thieves, lit the lamp
When the September 16, 2011, when the arrival time from work, 47-year-old Li Taisheng also Union Hospital East Side Building office busy. Office of the three walls are bookcases, placed on a folder of AIDS research, AIDS research in academic journals and professional books, and he was a breakthrough in AIDS research and honors trophy.
The more than 200 published papers, playing with the AIDS virus 20 years dealings doctor chatted about the latest find, look carefully: "We have long-term treatment of patients receiving HAART found a lot of tears with HIV, the virus here The new 'base'. "
Although as early as 1985, researchers in the tears of AIDS patients in the detection of the virus, but Li Taisheng studies have shown that, even if patients received long-term treatment, tears of HIV is still alive, and even when the amount has not been treated fairly.
"It seems to catch mosquitoes in the room, when you get killed most of the insecticide after mosquitoes, they found a corner lot is also dodging mosquitoes." Litai Sheng said.
This is the big room in the body, the AIDS virus in mosquitoes like dark. They bite healthy cells, its rapid replication after infection, infected more cells, eventually destroying the immune system. Room became untenable, patients infected with other diseases and ultimately death.
It is precisely because of this super-replication and attack power, this full-called "acquired immunodeficiency syndrome," the dreaded disease become a "plague of the century after history."
However, the "Mosquito" there are different types: a very active, flying in the room; another quietly hiding in the corner, for a low level of replication activity.
AIDS Research Center at Tsinghua University, Professor Zhang Linqi description, the global researchers in order to confront "Mosquito" brains. Their battle plan is clear - the first use of drugs to effectively control virus outbreaks, the eradication of visible enemies; kill activists, the ditch to control the virus, let them come up, and then destroy.
The first war plan is quite effective manner. Especially after 1996, made cocktail, this is like high insecticide treatment, can effectively control the most active of the AIDS virus. Data show that patients receiving treatment for 3 to 6 months after the blood of the virus is greatly reduced.
However, the second battle plans let doctors made difficult. Hiding in the corner of the confrontation in the treatment of the virus to alleys. Although they are not being active, but once the drug against the virus disappears, immediately resume the attack on nature. Even worse, they hide in the dark, who do not know where they live.
Li Taisheng, for example, had a patient adhering to a three-year treatment, the plasma has no HIV. But when patients are unwilling to continue medication, three months after drug withdrawal, "the virus all the resurrection."
In medical terminology, these are not hiding in the corner is called the active HIV virus repository. Before this, people know the main repository of static state refers to cells, including brain cells, blood lymphocytes, brain fluid, and so on.
Now, a new dens were dug out, it is tears.
"When the plasma where the virus under control when the tears in the virus is still there, indicating that some places in the body to release HIV. If we can continue to release the source of the virus found, it will be very significant discovery." Zhang Linqi that if Li Taisheng experiments to further confirm that the future of AIDS treatment will provide new research directions.
The greatest significance is also found here - you want to thief, first find the den of thieves, another corner of the room lit the lamp.
To cry out of the door with a smile AIDS
This study on tears, in fact, originated in a misunderstanding.
In 2005, Li Taisheng treatment of AIDS patients suffering from a cataract eye surgery done. He checks the aqueous within the eye in patients and found that there exists a large number of AIDS virus.
Li Taisheng will find available to the public, but was unknown to the reporter wrote, "experts said, the tears, there are AIDS virus!"
In fact, aqueous humor and tears are two different things. Aqueous humor in the eye within the eye anterior chamber and posterior chamber filled with a transparent liquid, under normal circumstances it was impossible to reach.
See the media's misunderstanding, Li Taisheng wanted to stand up and clarify, but hesitated up: "I can only prove the experimental room the water contains a virus, but there are no tears in the in the end, I have not done experiments unable to draw conclusions. "
Beginning in 2006, he led the other eight tears of AIDS patients began the study. They found 21 patients, including long-term study group included 16 patients receiving HAART, their blood has been negative for HIV, in addition to choose the two newly diagnosed patients, three patients with drug resistance after treatment as the control group.
Experiments in the Beijing Union Medical College Hospital for AIDS treatment center. Volunteers will provide patients with treatment tears came to this room, to provide tears for the experiment.
Although each person only needs 1 ml tears, but the experiment about 20 drops of this demanding tears - tears collected to ensure that no contamination, after the success of collection stored at low temperatures.
The biggest difficulty is how to enable patients to tears. "Not everyone as soon as the actor burst into tears, we have to think of ways to create a suitable atmosphere of tears." Collect the tears of a full-time nurse Li Yanling said.
In general, Li Yanling, and assistant in the office play "op" and more sad music, then sit down and chat.
"There is a working girl, in Wenchuan after the earthquake enthusiastically to donate blood, they find themselves in check with AIDS in her personal life is a bumpy, five years old when her mother died, her father is not good, finally a pain to find her boyfriend, but unfortunately passed away, the girl did not know that he is living with AIDS. "
Li Yanling patients have been impressed with the story of tears: "Perhaps the same boat, were relatively easy for people with similar situations with their own tears."
However, the need for so much trouble, not many people shed tears. "80% of patients take it easy tears, tears and some people are more yawn almost enough. It was also particularly easy to move, and sometimes I do not need to tell the story, they will talk about some of their sad things , to put it I can not help but cry along with them. "Li Yanling said.
When the tears welling about when, Li Yanling, and assistant out with a pipette tears. This instrument is like a pen, with a front tip, through the control button to tears inhalation. The whole process takes about 15 to 20 minutes.
However, Li Yanling, and patients will continue to chat. Talk to them, "recently found a new job," "soon on the high school kids" and the treatment of patients with positive results, with a smile to end the collection of experimental tears.
Get tears sample, the Li Taisheng the team began to step up testing in the laboratory. The results showed that, after long-term treatment of patients with tears in the amount of virus, and just people who were diagnosed with AIDS, the difference is not significant.
This conclusion, the experimental group lightly. They used three different experimental methods to study for five years, but whether it is 3 months of treatment of new patients, or patients treated for 3 years old, the conclusion is the same. After repeated scrutiny, Li Taisheng and colleagues will find only officially announced.
They published in the "AIDS" journal paper wrote: "We have evidence that, when the blood when the virus has been contained, there is still a lot of virus in tears, tears should be the repository of HIV." Thesis also clinical provides guidance, "HIV-positive patients in the eye examination or surgery, to strengthen the protection, careful handling."
So far, no case of patients around the world because of contact with infected tears
But this time it seems they misread the meaning. With "AIDS", "tears" to do keyword search, concluded the first few pages are mostly "Tears may become a new way of HIV transmission", which makes Li Taisheng see and shook his head.
"We proved that tears contain a virus, but does not mean the virus will spread this way." Litai Sheng said, "So far, the world has no case of infected cases due to contact with the tears."
In fact, AIDS is still a major blood-borne route of transmission, mother to child transmission and sexual transmission. Ministry of Health statistics show that in 2010, sexually transmitted AIDS in China has become the main route of transmission. As of end of October 2010, the cumulative reported HIV infections and 37 million cases of patients, including patients with more than 130,000 cases of death in 6.8 million cases.
Currently, the medical community has not found cure for AIDS, but have mastered the time to snatch from the hands of death skills. Cocktail therapy in the treatment, the AIDS already as high blood pressure, diabetes control, as can be. Currently, antiviral treatment can prolong life 30 years to 50 years, life expectancy than the fully cured only 10 years earlier. One example is the American basketball star Johnson. From the 1990s he began receiving treatment, is still alive today.
Another news is that HIV prevention may be within sight. September 12 in Bangkok, Thailand at the World Conference on AIDS Vaccine some news, so with 20 years of fighting AIDS Zhang Linqi quite excited. At the conference, scientists discussed the development of vaccines from the current test results, and the direction of the next five years, vaccine development and other topics.
"The biggest bright spot on vaccine development is 16,000 clinical trials in subjects who, we discovered that some protective and immune parameters are related. This is our next vaccine designed to provide a clue." Zhang Linqi said.
The finding may help humans to find a central target aimed to develop a vaccine, out of that, the AIDS virus will be nipped in the bud stage. Compared to destroy their brains to figure out how to sneak into the room, hiding in the shadows of mosquitoes, perhaps from the beginning to give mosquitoes a place will be slipped into a layer of screens more effective.
At the same time, Li Taisheng continue to "stop the AIDS virus" and busy. Facing a computer screen full of misunderstanding reports, Li Taisheng plans with the English translation of Chinese papers published in Chinese academic journals, in people that fear of AIDS is also the case, "at least it can reduce misunderstanding."
