Japan could become one of the first countries in the world to end the HIV epidemic, says the president of Gilead Sciences Japan, Kennet Brysting. The idea for now could seem a little too ambitious, but it is not entirely unrealistic, given that the availability of medicines that can prevent transmission of HIV. Drugs are not the cure, but control over the spread of virus to the point where the disease is no longer a major public health threat.

What Is The Role Of Preventative HIV Medicines?

Gilead's have two key drugs, Truvada and lenacapavir. These two are playing a crucial role in prevention. Truvada is taken as a daily pill, while lenacapavir requires two injections per year. It can make the virus undetectable in infected individuals and prevent transmission to those who are not infected yet. In trials, lenacapavir showed 100% efficacy in preventing HIV infections. This is why it is describe as "almost a vaccine".

In 2024, Japan also approved Truvada for HIV prevention, but the country has yet to approve lenacapavir for the same. Until now, people in Japan had been importing generic versions of Truvada or purchasing it from clinics that source it from overseas.

HIV In Japan

Up until now, Japan reported around 25,000 HIV infections, whereas 669 new cases were reported in 2023. For seven consecutive years, the number of new infections remained under 1,000. The downward trend thus shows that the virus has been controlled, however, getting to zero new infections remains the ultimate goal.

Brysting too acknowledged that simply having effective drug is not enough. What is important is to have a proper implementation, access and healthcare support to make sure that these treatments are widely available and effective.

What Are The Challenges In Implementation?

The biggest challenges is testing rates. There is a need to increase testing rates. At this very moment, around 86% people infective with Japan have been tested, but the goal is to increase it up to 95%, with an ideal goal of 100%. Without widespread testing, many infected people may not even know that they are infected and it could transmit the virus.

Another measure issue is the cost of preventative medication. While Japan's health insurance covers treatments for diseases, it does not cover preventative drugs. Those who purchase Truvada for prevention, pay around $470 per month. Some clinics in Tokyo offer generic alternatives too, which is cheaper, but they are not ideal.

Better Healthcare Support

Brysting expressed concern that individuals importing medications might not be consulting doctors regularly, which is essential for monitoring HIV status and overall health. Truvada users need to be tested for HIV initially and every three months, along with screenings for other infections and kidney function checks. Without proper medical supervision, there is a risk of misuse and inadequate protection.

Gilead is in discussions with Japanese authorities to improve access and insurance coverage for Truvada, and progress is being made. Japan has shown efficiency in approving critical medicines, as seen during the COVID-19 pandemic when Gilead’s remdesivir was approved in just three days.

What Is The Way Ahead?

Gilead at this moment is not only focused on HIV and hepatitis C, but also expanding into oncology with innovative treatments like CAR-T cell therapy, which strengthens a patient's immune system to fight cancer.

However, Japan’s strict approval processes can slow down drug availability. Phase 3 clinical trials often need to be conducted within the country, and Japan tends to approve medicines much later than other regions. For instance, Truvada was approved for prevention in Japan 12 years after the U.S. and nearly 20 years after its approval for treatment. inancial factors also play a role. The Japanese government adjusts drug prices annually, often reducing them, which can make long-term investment challenging for pharmaceutical companies.

Three suspected hantavirus patients have been evacuated from the ship and are on their way to receive medical care in the Netherlands, said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, today.

The three patients evacuated from the MV Hondius cruise ship include

• a 56-year-old British national,
• a 65-year-old from Germany,
• a 41-year-old from the Netherlands.

The WHO chief noted that the global health agency “continues to work with the ship’s operators to closely monitor the health of passengers and crew, working with countries to support appropriate medical follow-up and evacuation where needed”.

“Monitoring and follow-up for passengers on board and for those who have already disembarked has been initiated in collaboration with the ship’s operators and national health authorities,” Dr Ghebreyesus said.

Hantavirus: 8 Suspected Cases, 3 Deaths

Also read: Hantavirus: Symptoms, Risks, and Prevention

Some passengers aboard the Hondius began experiencing serious health complications after the ship, carrying about 150 passengers, departed Argentina on April 1.

Initially, it was considered a severe acute respiratory infection; later, three people died.

• April 11: A 70-year-old Dutch national became the first passenger to die while on board the ship. His death has not yet been confirmed as due to hantavirus.
• April 24: The man’s 69-year-old wife travelled alongside her husband’s body from St Helena, a British island in the South Atlantic, to Johannesburg. Her condition deteriorated during a flight the next day, and she was taken to the hospital.
• April 26: The woman died in a hospital in South Africa. She is the first confirmed hantavirus case.
• April 27: A second sick passenger, a British national, was flown to South Africa and remains in a critical but stable condition in hospital with hantavirus.
• May 2: A German national died while on the ship; it is unclear if the passenger was infected.
• May 5: The Swiss government announced that a man who travelled home from his trip from South America on the MV Hondius cruise ship at the end of April visited the University Hospital Zurich after experiencing symptoms. He was immediately placed in isolation, with authorities saying there is no danger to the public. His wife, who accompanied him, has not shown symptoms but is also isolating as a precaution.
• May 6: WHO announces the evacuation of three infected passengers.

What Is Hantavirus?

Also read: Hantavirus Outbreak: How The Rare Rodent-Borne Virus Spreads

According to the WHO, hantaviruses are zoonotic viruses that naturally infect rodents and are occasionally transmitted to humans.

Symptoms include:

• Fever
• Headache
• Abdominal pain
• Diarrhea

Hantavirus: The Andes strain?

A team of scientists at South Africa’s National Institute for Communicable Diseases identified the strain of hantavirus linked to the cases.

In a presentation to parliament, the South African health minister said the Andes strain of hantavirus, which can spread human-to-human, had been identified in two people who disembarked from the cruise ship.

The Andes virus is the only hantavirus strain with documented human-to-human transmission and is more commonly found in South America.

Some people love tea, some can't get enough of coffee, but rarely does one think about if the same could influence disease risk later in life. According to a new study, women's risk of osteoporosis could be influenced by their choice of tea or coffee. Osteoporosis is a common occurrence in women aged 50 years and above. Statistics suggest that one in three women will likely be diagnosed with the disease, which renders the body incapable of replacing old bone after it undergoes wear and tear. This means bones become weak, brittle, and more prone to fractures. Bone problems at an advanced age in women can also slow down healing.

High-risk groups for osteoporosis

Older women are at a higher risk of osteoporosis, and that is because of oestrogen. Oestrogen supports bone metabolism, and its levels drop after menopause. Surgery can help remove a woman's ovaries, thereby resulting in the same effect. Researchers at Flinders University in Australia evaluated tea- and coffee-drinking habits of approximately 9,700 US women aged 65 years and above. Participants were required to self-report their tendencies in the survey on four occasions over a 10-year period.

The study also gathered data on women's bone health, measuring bone mineral density in the hip and the narrow connection to the hip with X-ray beams to deduce mineral levels in the bone. Researchers found that women who regularly drank tea had significantly higher hip BMD than those who did not. This could be because of tea compounds known as catechins that could provide the boost cells need to build strong bones. Even smaller differences can significantly improve bone health.

What are the benefits of tea for women's health?

Researchers noted that tea intake could be particularly beneficial for women dealing with obesity. Coffee habits, alternatively, had a different impact on BMD. Studies suggest that women who drank more than five cups of coffee a day were more likely to have lower BMD levels, thereby suggesting that caffeine can negatively affect calcium absorption in the body. Furthermore, experts noted that drinking any amount of coffee can reduce BMD levels in women, especially those who consumed high levels of alcohol.

Scientists note that, because of the limited scope of the study, more research is required in this area to ascertain the results. However, the study offers insights into the possible benefits of drinking tea for women living with osteoporosis. It can go a long way in improving overall wellness and long-term bone health in women.

The research is published in Nutrients.

A team of scientists at South Africa’s National Institute for Communicable Diseases has identified the strain of the Hantavirus that has caused three deaths and infected seven so far aboard the MV Hondius ship in the Atlantic Ocean.

In a presentation to the parliament today, the South African Health Minister revealed that the Andes strain of hantavirus, which spreads human-to-human, has been identified in two people who came off the cruise ship.

“Incredible work of @nicd_sa, South Africa, in sequencing the #hantavirus. There has been excellent collaboration as @WHO

works to coordinate efforts and actions of governments, experts around the world, the Ship to keep people safe,” said Dr. Maria Van Kerkhove, director of epidemic and pandemic preparedness and prevention at the World Health Organization (WHO), in a post on social media platform X.

The NICD scientists found that the Andes strain was the cause of infection in a Dutch woman who died in Johannesburg, and a British man who is still in hospital. Both had become ill on the ship, Reuters reported.

“This is the only strain that is known to cause human-to-human transmission, but such transmission is very rare and, as said earlier, only happens due to very close contact,” the Minister said.

Other strains of hantavirus are more commonly transmitted to humans through contact with infected rodents or their urine, droppings, or saliva.

Also read: Hantavirus Outbreak: WHO Flags 6 Suspected Cases; How The Rare Rodent-Borne Virus Spreads

What is Hantavirus? How Deadly Is The Andes Strain?

As per the WHO, hantaviruses are zoonotic viruses that naturally infect rodents and are occasionally transmitted to humans.

Globally, an estimated 100,000 to 200,000 hantavirus infections occur each year. The majority of these cases are in Asia, particularly China. Most are sporadic or occur in small clusters, linked to contact with infected rodents.

“Hantaviruses are a group of viruses carried by rodents that can cause severe disease in humans. Infection with hantaviruses is found in many parts of the world. Thousands of infections are estimated to occur each year," Van Kerkhove said.

The Ande virus is the only strain of virus with documented human-to-human transmission. It is more common in South America.

"Although uncommon, limited human‑to‑human transmission of HPS due to the Andes virus has been reported in community settings involving close and prolonged contact. Secondary infections among healthcare workers have been previously documented in healthcare facilities, though they remain rare,” WHO said in its situation report.

The WHO also currently assesses the risk to the global population from this event as low and will continue to monitor the epidemiological situation and update the risk assessment as more information becomes available.

"People really do need to understand that there are different degrees of person-to-person transmission," said Angela Rasmussen, a virologist with the University of Saskatchewan's Vaccine and Infectious Disease Organization, as quoted by CBS News.

Read More: Hantavirus on Cruise Ship: Symptoms, Risks, and Prevention

In the case of hantavirus, individual people are usually the end of the line, Rasmussen said, noting that this makes this cluster of cases unusual.

"So this virus — right now anyways — doesn't seem to be as big a risk as something like flu," the expert said.

While symptoms might not appear for weeks, the strain can escalate quickly, leading to severe respiratory failure with a death rate of roughly 40 per cent.