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.

Artificial intelligence has taken another step forward in biology. Scientists have created viruses designed by AI and shown that they can work in the laboratory, showing promise for new treatments. But this has also triggered concerns about biosecurity.

The viruses are bacteriophages, or viruses that infect bacteria rather than humans. Researchers led by Dr Brian Hie, a chemical engineer at Stanford University, used AI models called Evo1 and Evo2 to design functioning genomes for these viruses. The models were trained using genetic data from around 2 million bacteriophages.

The researchers generated thousands of potential viral genomes and selected nearly 300 to manufacture and test in the laboratory. Only 16 ultimately proved viable.

However, a combination of the AI-designed viruses was able to kill two strains of E coli that had developed resistance to naturally occurring bacteriophages.

How Can AI Design A Virus?

The technology works like the large language models behind AI chatbots, but instead of learning patterns in human language, genome language models learn patterns in genetic sequences.

The AI was able to generate genetic instructions for new bacteriophages, which were then produced in the laboratory and tested against bacteria.

This matters because bacteriophages are already being explored as a treatment for persistent bacterial infections.

If scientists can rapidly design viruses that target specific bacteria and overcome resistance, the approach could strengthen phage therapy, particularly as antibiotic resistance continues to complicate treatment.

The researchers said the ability to rapidly design genomes and adapt them to particular bacteria could “transform phage therapy” and expand biotechnology.

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So Why Are Scientists Worried?

The viruses created in this experiment were designed to infect bacteria. The researchers also deliberately excluded genetic information from viruses that infect humans, animals and plants from the AI's training data, reducing the chance of the system generating dangerous pathogens.

But the experiment demonstrates something bigger: AI can now produce functioning viral genomes.

That raises questions about what could happen if similar technology were trained on genetic information from harmful pathogens.

Prof Tom Inglesby and Dr Moritz Hanke of the Center for Health Security at Johns Hopkins University warned that the ability to create viral genomes using generative AI now exists, but the systems and regulations needed to govern the AI have not caught up.

They warned that genomes designed for human, animal or plant pathogens could potentially generate new threats that existing measures may not be equipped to contain.

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Is AI-Created Biological Warfare Already A Reality?

Tom Ellis, a professor of synthetic genome engineering at Imperial College London, said the experiment was impressive but pointed out that bacteriophages have extremely small and relatively simple genomes.

He also argued that fears surrounding fully AI-designed pathogens may currently be overstated. He said that modifying existing pathogens to make them more dangerous remains a much easier and more immediate concern.

Dr Filippa Lentzos of King's College London said the solution should not focus only on AI. Instead, safeguards should extend across the entire process, including AI development and access, research, DNA synthesis screening and lab biosafety.

An 18-year-old woman is in critical condition after an acidic substance was allegedly administered instead of an anaesthetic during nose surgery at a private hospital in Israel.

Police have launched an investigation into suspected negligence after the woman suffered severe burns to her face and respiratory system during the procedure on Friday.

What Happened During The Surgery?

The teenager had previously been injured in an accident on Highway 35 in southern Israel in 2024. She was admitted to the private hospital on Friday morning for a nose surgery.

According to allegations being investigated by police, the anaesthesiologist confused two substances and administered an acidic substance instead of the anaesthetic drug. The error reportedly caused severe burns to the woman's face and respiratory system.

The surgeon eventually noticed what was happening and stopped the procedure. A medical team was called into the operating room and the woman was intubated, with a breathing tube inserted into her windpipe. She was then sedated and placed on a ventilator.

She was subsequently transferred to Tel Aviv's Sourasky Medical Center, where she was admitted to the intensive care unit.

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Chemical Injuries In The Respiratory System

The respiratory system is particularly vulnerable to chemical injuries. Damage to the airway can cause severe inflammation and swelling, making it difficult for a person to breathe.

This is why doctors may need to secure the airway quickly through intubation and use a ventilator to support breathing while the injury is tended to.

In this case, the damage was serious enough to require another emergency operation. On Saturday evening, an expanded team of around 10 doctors at Sourasky Medical Center performed surgery to treat severe damage to her windpipe. The young woman remained sedated in the intensive care unit after the procedure.

More updates about her well-being are being awaited.

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Police Investigate Medical Negligence

The local police are now investigating the incident, particularly how the alleged mix-up of the acidic substance and anaesthetic drug occurred.

The most crucial factor to investigate in this case is whether it was an unavoidable error or gross medical negligence.

The incident has also raised concerns about careful identification and handling of medication and substance during critical surgeries surgery.

Anaesthesia involves the administration of multiple drugs and substances, making accurate identification and handling critical to patient safety.

The Israeli Health Ministry said it had not been notified about the incident. “According to an inquiry conducted by the ministry, the incident was not reported to the Health Ministry,” the ministry said in a statement.

The investigation remains ongoing, and authorities have not yet established who was responsible for the alleged error or whether any medico-criminal charges will follow.

For now, the 18-year-old remains in intensive care as doctors continue treating the severe injuries to her airway and respiratory system.

Back pain is often treated as a problem that comes with ageing, but new research suggests that some forms of spinal degeneration may have specific biological trigger, and an existing osteoporosis drug could help treat it.

A study published in Communications Biology found that a class of osteoporosis drugs called bisphosphonates reduced abnormal mineralisation in the spinal tissues of genetically modified zebrafish.

The findings show promise in treating intervertebral disc degeneration, a major cause of chronic back and neck pain.

What Did The Study Find?

Researchers from the University of Edinburgh and University of Bristol studied zebrafish lacking a functioning copy of the col9a1b gene. This gene is linked to collagen IX, an important structural component of spinal discs.

As the fish aged, they developed changes resembling human disc degeneration. Their vertebrae began to fuse and mineral deposits accumulated in the ligaments between the vertebrae, making the normally flexible spinal structures increasingly hard.

The researchers found that the mineralisation was preceded by deterioration of the structural tissue supporting that supported the developing spine.

They also identified changes in lipid metabolism, mTOR signalling, phosphate regulation and vitamin A-related pathways.

Most importantly, when researchers treated the animals with etidronate, a bisphosphonate, mineral accumulation was reduced. Other interventions targeting fat metabolism also reduced spinal fusion.

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Why Is Disc Mineralisation A Problem?

Intervertebral discs act as cushions between the bones of the spine. They allow the back to bend and move while absorbing daily physiological stress.

With disc degeneration, the disc's structure can wear off. Abnormal mineralisation can make these tissues stiffer and contribute to vertebral fusion, making movement challenging and contributing to pain.

Currently, there are no medications that can reliably stop or reverse intervertebral disc degeneration. Treatment generally focuses on pain management, physiotherapy and lifestyle measures, while severe cases may eventually require surgery.

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More About The Osteoporosis Drugs

Bisphosphonates are already widely used to protect bones in people with osteoporosis. They work by slowing the activity of cells that break down bone.

In this study, however, their potential benefit appeared to involve something different: preventing minerals from accumulating where they should not.

Study lead Dr Erika Kague said the research could help with alternatives to surgery. “For decades, surgery has been the only real answer for disc disease,” Kague said.

She added that the findings suggest several ways of slowing the process, including a drug already used in patients.

Dr Caroline Aylott of Arthritis UK said the findings offer “fresh hope” for the millions of people living with back pain and could help scientists move closer to new treatments.

Researchers caution that the findings are promising but still early and that larger trials will be needed to validate the study. Also, this was an animal study, not a clinical trial in people with back pain.

Researchers will need to establish whether the same biological process occurs in humans and whether bisphosphonates can safely and effectively prevent or slow disc degeneration in patients.