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.

Fatty liver disease, which affects nearly 30% of adults worldwide, may comprise five biologically distinct subtypes, according to new research.

Researchers from the Mayo Clinic and Virginia Tech in the US found that each subtype may carry different risks of liver failure, cancer, heart disease and other serious complications.

The study, published in Nature Communications, suggests that metabolic dysfunction-associated steatotic liver disease (MASLD) can develop through different biological pathways. Some are closely linked to obesity and diabetes, while others appear to be driven by inherited genetic factors.

The findings suggest that genetic forms of the disease may progress to advanced liver damage even in people without typical metabolic risk factors.

Why Fatty Liver Disease Can Be Dangerous

Also read: NAFLD to MASLD: Experts Explain Why This Common Yet Dangerous Liver Condition Got Renamed

MASLD, previously known as nonalcoholic fatty liver disease, develops when excess fat accumulates in the liver. Many people experience no noticeable symptoms, allowing the condition to go undetected for years.

Although the disease does not always cause serious complications, it can progress to inflammation, scarring and permanent liver damage. In advanced cases, it may lead to cirrhosis, in which extensive scarring impairs liver function.

MASLD is a major contributor to cirrhosis, liver cancer and liver transplantation worldwide. Understanding why some patients develop severe complications while others do not is therefore an important research priority.

Genetic Analysis Reveals Five Distinct Subtypes

To investigate the differences, the researchers analyzed genetic sequencing results alongside detailed medical records from more than 4,600 patients with MASLD.

The data included liver enzyme measurements, body mass index, blood lipid levels and other indicators of metabolic health. The researchers also examined coexisting conditions, including diabetes, depression and sleep apnea.

Using computational models, they identified five groups of patients who shared distinct biological characteristics. The findings suggest that people with the same MASLD diagnosis may have different underlying disease processes and risks of complications.

“When clinical and genomic data are analyzed together at this scale, you begin to see patterns of disease progression that would otherwise remain hidden,” said Shulan Tian, Ph.D., co-senior author and a bioinformatician at Mayo Clinic. “Once you separate these subtypes, you can start to match treatments to the biology that's actually driving the disease.”

Links to Depression, Sleep Apnea and Migraines

Read More: Lancet Study Shows Metabolic Liver Disease To Rise Over 38% By 2050: What’s Behind The Surge

The findings also suggest that the differences between MASLD subtypes extend beyond the liver.

Researchers identified associations between specific subtypes and conditions such as depression, sleep apnea and migraine. These links suggest that the biological processes underlying some forms of fatty liver disease may also be associated with health problems affecting other parts of the body.

However, the findings do not establish that MASLD directly causes these conditions.

Could the Findings Improve Treatment?

Identifying distinct subtypes could eventually help doctors recognize high-risk patients earlier, improve screening and develop more personalized treatment strategies.

Eric Klee, a research and innovation leader at Mayo Clinic, said the approach could help researchers better understand disease progression and identify opportunities to intervene before severe damage occurs.

The team plans to evaluate the findings in larger and more diverse patient populations and investigate whether the subtypes respond differently to treatments, including GLP-1 receptor agonists.

If further studies validate the results, the research could help move MASLD care toward earlier intervention and treatments tailored to the biological processes driving each patient's disease.

Even as Republicans struggle to win over female voters two weeks before the midterm elections, US President Donald Trump has signed an executive order backed by First Lady Melania Trump to advance the health of women in America.

The initiative will establish a new Division of Women’s Health within the National Institutes of Health (NIH) and a Women’s Health Task Force within the White House.

The executive order aims to advance women’s health by ensuring that medical research, diagnosis, prevention and treatment reflect the highest-quality scientific evidence, to improve health outcomes at every stage of life.

“Our mission must serve women at every stage of life, from young girls just starting out to mothers dealing with a complex range of responsibilities, to mature women who deserve to have vitality, dignity and independence,” the first lady said.

Trump called the announcement “a big deal” and credited himself with introducing a new initiative. “When I heard about it, I said, ‘Are you sure they don’t have that?’” the president said. “Who the hell wouldn’t have a women’s health division?”

Is This the First US Women’s Health Research Initiative?

Also read: EXCLUSIVE: Ex-CDC Vaccine Advisor Says Measles Outbreak Bigger Than Reported, Slams RFK Jr’s ‘No-See Evil’ Approach

The US has had a dedicated office for women’s health research since 1990, when the Office of Research on Women’s Health was established at the NIH during President George H.W. Bush’s administration.

In April 2025, a few months after Trump took office, the Department of Health and Human Services decided to slash funding for the Women’s Health Initiative, a long-running, taxpayer-funded study of a broad range of women’s health issues that began in the 1990s. Officials restored the funding after a public outcry.

“These studies represent critical contributions to our better understanding of women’s health,” Emily G. Hilliard, a department spokeswoman, said at the time.

The new division will operate in coordination with the existing Office of Research on Women’s Health rather than replace it. Under the order, it must be established within an appropriate NIH institute or center within 90 days.

The White House said the move is intended to broaden the government’s focus beyond research and prioritize translating scientific discoveries into clinical care for women and girls.

What Are Melania Trump’s Five Pillars of Women’s Health Innovation?

Read More: Nearly 4,000 Measles Cases In US: CDC Director Says MMR Vaccine Is ‘Absolutely Safe’

Melania highlighted her “First Lady’s Five Pillars of Women’s Health Innovation,” which outline the initiative’s proposed approach:

1. Direct research funding: Support research aimed at finding cures for conditions that uniquely affect women.
2. Use artificial intelligence: Leverage advanced AI capabilities to improve understanding of female biology and accelerate medical discoveries.
3. Speed up treatment development: Accelerate the transition of promising therapies from laboratories to female patients while maintaining strict safety standards.
4. Improve access and affordability: Ensure medical breakthroughs are accessible and affordable to women, regardless of their financial circumstances.
5. Encourage open conversations: Replace generations of silence with open discussion, education and compassion around women’s health.

The Women’s Health Task Force will work in collaboration with the private sector to advance new technologies and solutions for women’s health.

It aims to develop high-quality, scientifically supported medical information and care while advancing new treatments, therapies and cures for women.

It will be led by White House Chief of Staff Susie Wiles, who recently completed treatment for breast cancer, and Health and Human Services Secretary Robert F. Kennedy Jr.

While Trump said the panel will coordinate with various federal agencies and programs, the executive order does not specify funding targets.

Which Health Conditions Will the New Division Study?

According to the Department of Health and Human Services, the division will study conditions that uniquely or disproportionately affect women, including:

• Cardiovascular disease and cancer
• Autoimmune and inflammatory conditions
• Chronic pain
• Endometriosis and fibroids
• Polycystic ovary syndrome (PCOS)
• Infertility and menopause
• Alzheimer’s disease and osteoporosis.

American singer and actress Selena Gomez has said that vaping nicotine has changed her voice, expressing concern that the effects may be irreversible.

"I'm not gonna be able to change my voice," the 34-year-old singer said in a candid Instagram post on Sunday. "I vaped nicotine a lot."

Describing how difficult it is to quit nicotine, Gomez added that "it's just not worth it".

"It is so stupid and..it changed my voice. So, if you guys don't like listening to my voice, that's totally understandable. I don't mind. Just don't listen to it. Just don't listen," she said.

Gomez also expressed hope that she would be able to quit vaping for good.

"It's really hard, but I know if you are going through something you can get through it too. It sucks," she added.

How Does Vaping Affect Your Vocal Cords?

Vaping is often perceived as a cleaner alternative to smoking because e-cigarettes do not burn tobacco. However, the aerosol produced by these devices is not harmless water vapor and can contain substances that may affect respiratory and cardiovascular health.

E-cigarette aerosol may contain:

• Nicotine: A highly addictive substance.
• Heavy metals: Including lead, nickel and tin.
• Volatile organic compounds: Some of which can be harmful.
• Flavoring chemicals: Which may have different effects when inhaled.
• Ultrafine particles: That can penetrate deep into the lungs.

These substances may also affect the throat and vocal cords, potentially contributing to irritation, dryness and changes in voice quality.

Also read: 5.4 Million Over-16s Now Vape in Britain: Why E-Cigarettes May Not Be Safer

Can Vaping Cause Hoarseness and Voice Changes?

Research suggests that e-cigarette use may affect the vocal folds, the structures in the voice box that vibrate to produce sound.

A 2025 study published in the Journal of Voice examined the potential effects of e-cigarette use on vocal health.

“E-cigarette use can cause inflammation of the epithelium and mucosa of the vocal folds, and their components can cause dryness, compromising vocal homeostasis, increasing the risk of coughing and breathing difficulties, deteriorating the vocal folds, and worsening voice quality,” said the researchers from Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.

By irritating and drying the vocal folds, e-cigarette aerosol may contribute to hoarseness, coughing and vocal strain. However, more research is needed to establish the long-term effects of vaping on the voice, including whether it can cause permanent voice changes.

Selena Gomez Has Previously Spoken About Throat Swelling

Read More: FDA To Speed Up Approval Process For Vapes & Nicotine Pouches: Does It Mean They Are Safer Than Cigarettes?

Gomez, who has lupus, a chronic autoimmune disease, has previously suggested that she experiences throat swelling that may affect her voice.

During an Instagram Q&A in December, she said: "Sometimes things happen. I get weird. My throat kind of swells inside sometimes. That's all."

Lupus can affect different parts of the body and, in some cases, cause inflammation involving the larynx, or voice box. This may contribute to hoarseness, a raspy or breathy voice, vocal fatigue or changes in pitch.

It is not possible to determine whether Gomez's reported voice changes are related to vaping, lupus or another cause based on her public comments alone.

When Should You Seek Medical Advice for Voice Changes?

Persistent hoarseness, a raspy voice or difficulty speaking should not be ignored, particularly if symptoms do not improve. A clinician may examine the vocal cords to identify the cause.

People experiencing breathing difficulty or significant throat swelling should seek urgent medical attention.

Quitting vaping reduces further exposure to potentially irritating substances. Behavioral support and appropriate smoking-cessation treatments can help people manage nicotine dependence and withdrawal symptoms.