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.

A 24-year-old student from West Bengal has reportedly become the first confirmed heatstroke case of the season in India’s national capital.

According to doctors at Dr Ram Manohar Lohia (RML) Hospital, the young man was admitted in critical condition after developing hyperpyrexia — an extremely high body temperature, and altered mental status while travelling by train to the national capital.

"We received our first heatstroke patient at the RML Hospital on the intervening night of May 20-21. The 24-year-old youth from West Bengal was travelling on a train when his health deteriorated,” said Dr Ajay Chauhan, Director Professor of Medicine, at RML, PTI reported.

“He was brought to the hospital in an unconscious state. We took immediate action and tried to cool down his body,” he said, adding that the boy "is admitted to the medicine ward and is still critical".

As per the doctors, the student had no known pre-existing medical condition, and other possible causes of his symptoms were ruled out before heatstroke was diagnosed.

What Is Heatstroke?

Heatstroke is the most severe form of heat-related illness and is considered a medical emergency. It occurs when the body loses its ability to regulate temperature due to prolonged exposure to extreme heat or dehydration. In most cases, body temperature rises above 104°F (40°C), which can damage the brain, heart, kidneys, and muscles.

“The general features of a patient with heat stroke are: first, his or her body temperature will be very high. It will not be around normal levels like 104, 105, or 106—it will be significantly elevated. Second, the person may be delirious, confused, or even in a state of unconsciousness or coma. The breathing will also be labored,” Dr. Naval Vikram, Professor, Department of Medicine, at the AII India Institute of Medical Sciences (AIIMS), told HealthandMe.

During a heatwave, most patients improve quickly with rest, oral fluids, cooling measures, and moving to a shaded or air-conditioned environment.

"However, if heat exposure continues and the body’s cooling mechanisms begin to fail, the condition can progress to heat stroke, which is a medical emergency. In heat stroke, body temperature often rises above 104°F," Dr. Vaibhav Mishra, Senior Director & Head, CTVS, Max Super Speciality Hospital, told HealthandMe.

What may initially appear as confusion, disorientation, or irrelevant talking can rapidly worsen into:

• altered consciousness,
• seizures,
• coma,
• death.

Heat Stroke: How Can One Prevent?

Also read: Bundibugyo Ebola Cases Rise To 600 As Scientists Investigate Spillover Event

While it may be impossible to avoid rising temperatures, the focus should be on how much you can protect yourself. Experts suggest the following measures:

• Avoiding exposure to extreme heat as much as possible.
• In case of being exposed, make sure to cover yourself—cover your head and upper body, use an umbrella, stay hydrated, and take breaks in between.
• If you have to work in a hot environment for a couple of hours, take a break in a cooler or temperature-controlled environment for at least half an hour before resuming, rather than continuously working in the heat. These steps can help prevent heat-related problems.
• If symptoms do occur, and it is heat exhaustion, take rest and avoid further activity for some time.
• In more severe cases—if someone shows symptoms like loss of consciousness or very high body temperature—they should be taken to a hospital immediately. Do not try to manage such cases at home.

What Does the IMD Say?

The India Meteorological Department (IMD) has warned of severe temperatures across several states.

"Heat wave to severe heat wave conditions likely to continue to prevail over northwest & central India during the week and over East India during the next 5 days," the IMD said, in its latest update on May 20.

It added that severe heat conditions will persist for at least the next 72 hours across Delhi-NCR, Rajasthan, Uttar Pradesh, Punjab, and Haryana. Temperatures in several cities are expected to touch 47°C to 48°C, with Banda currently emerging as the hottest place in the country.

Alzheimer's disease is a progressive neurodegenerative disorder that affects millions of people worldwide, and it has a long preclinical stage. It is mostly diagnosed at an advanced age, but according to doctors, it begins years before the symptoms become evident. New research shows that blood biomarkers, along with self-reported memory concerns, could give an explanation as to how Alzheimer's disease worsens over time. Therefore, the best time to nourish brain health is during your 40s or 50s.

For this study, researchers used data from the Dunedin Study at the University of Otago, which had been following a few participants for over 50 years. Researchers found a protein known as pTau181, which is associated with self-reported problems linked to memory and thinking skills. Participants were 45 years old at the time of assessment. Typically, an Alzheimer's diagnosis happens at or after the age of 65–70.

When it comes to Alzheimer's, the treatments could only slow down disease progression, but they do not fully restore cognitive function, which is usually lost in the advanced stages. Researchers noted that these treatments work best when taken early, which makes it important to identify the early signs of Alzheimer's disease.

Dementia prevention

Researchers noted that different types of dementia can look different at various stages of the disease. However, the course of progression and treatment can vary from patient to patient. In the past, Alzheimer's could only be diagnosed post-mortem or through invasive procedures such as lumbar punctures. However, researchers are now working towards identifying blood biomarkers that could offer minimally invasive ways to identify high-risk patients for Alzheimer's.

Can Alzheimer's be detected early?

Researchers note that Alzheimer's can be detected in the early stages, and this could provide an opportunity for prevention. It may also offer health benefits for ageing and the brain. Some lifestyle changes include supporting people to remain active, continue engaging in social activities, and address factors such as hearing loss or hypertension. Preventive approaches in this case have worked more effectively the sooner they are implemented. Therefore, it is important to study middle-aged populations, as the signs can start appearing long before the disease is finally diagnosed.

Forgetfulness as an early sign

As people get older, they notice that their memory is not as strong as it used to be. Forgetfulness gradually becomes a common issue with advancing age. However, in some cases, these problems indicate a different story altogether. Recent research shows that minor changes in cognition often begin long before diagnosis, and that is the first moment the disease is truly felt.

Screening for biological Alzheimer's markers

When it comes to screening for biological markers, combining them with subjective memory function reports can help distinguish the earliest signs of Alzheimer's from normal ageing. Proteins such as pTau181 are much higher in Alzheimer's patients, but researchers have not yet ascertained when they begin to accumulate. While researchers did not find that pTau181 was linked to MRI scans measuring cognitive test performance at 45, there were two possible explanations for this:

1. pTau181 might increase during the early stages of Alzheimer's, when people start to experience worsening memory, but it does not appear on an MRI.
2. Alternatively, it could be that high pTau181 is not linked to Alzheimer's risk in midlife, but the protein could still be useful for Alzheimer's diagnosis in older adults.

Vitamin C boosts immunity—and we have known that for a long time now. However, this nutrient has a more crucial role to play. According to a new study from researchers at the University of Waterloo, vitamin C supplements could have a role to play in influencing chemical reactions in the digestive system that are associated with cancer development. Researchers used mathematical models to examine how this happens. Over several decades, North American diets have witnessed a steady rise in exposure to nitrites and nitrates. These are compounds found in cured meat, vegetables, and fruits that are grown in polluted soil and water.

How do nitrates and nitrites affect health?

Nitrates and nitrites play a crucial role in heart and neurological health. They also affect the stomach when it undergoes a chemical reaction known as nitrosation. This leads to the formation of certain chemicals that scientists say can increase cancer risk. Researchers said that, since the 90s, researchers have been working to understand the link between cancer and cancer-causing compounds and have only received conflicting results. The vitamin C study, however, can help explain the inconsistencies.

The team of researchers also developed a mathematical model of the stomach, plasma, salivary glands, and small intestine, and simulated how nitrates and nitrites move through your body and change over time. The researchers' model showed that, when vitamin C is present in foods like spinach and leafy greens, along with nitrates, it could work well to reduce cancer risk in the long run.

Do you need vitamin C supplements daily?

The study also found that taking vitamin C supplements regularly after every meal could have a positive impact on health. It could be effective in reducing the formation of nitrosation products that are linked to cancer risk from nitrates and dietary nitrites found in foods like salami and bacon. Researchers stated that this could help support future research. This acts as a roadmap for future clinical research, and it can help identify the key drivers of these potentially harmful chemical reactions, such as meal timing, nitrite exposure, oral microbiome activity, antioxidant intake, and gastric conditions.

The study, titled “Vitamin C as a Nitrosation Inhibitor: A Modelling Study Across Dietary Patterns and Water Quality”, is published in the Journal of Theoretical Biology.

What are the best natural sources of vitamin C?

Fruits and vegetables are the best sources of vitamin C, some of the best sources being:

1. Guava
2. Amla
3. Bell peppers
4. Kiwi
5. Oranges
6. Lemons
7. Grapefruit
8. Berries
9. Papaya
10. Green chillies

If you are looking for ways to maximise your vitamin C intake, ensure that, from the above list, foods that need cooking are only lightly steamed. Since vitamin C is heat-sensitive and water-soluble, prolonged cooking and boiling can destroy the nutrient.