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 new blood test may help identify microscopic precancerous changes linked to ovarian cancer before a tumour develops, according to a study published in Nature Medicine. Researchers found that the test could detect a molecular signal associated with an early precursor of high-grade serous ovarian cancer, one of the most common and aggressive forms of the disease.

The study, led by researchers at the Hoag Family Cancer Institute in California, identified elevated levels of an RNA molecule called Tu-Stroma in blood samples from women with a condition known as serous tubal intraepithelial carcinoma (STIC).

The findings could eventually help identify women at increased risk of developing ovarian cancer, especially those with inherited genetic mutations.

What Is STIC And How Is It Linked To Ovarian Cancer?

High-grade serous ovarian cancer mostly originates in the fallopian tubes rather than directly in the ovaries. It may begin with microscopic changes in the cells lining the fallopian tubes, known as serous tubal intraepithelial carcinoma or STIC.

These lesions are precancerous, which means they are not invasive cancer but can lead to the development of high-grade serous ovarian cancer.

STIC is difficult to detect because the abnormal cells are microscopic and cannot be identified through routine imaging. They are often discovered incidentally when women undergo surgery to remove their fallopian tubes or ovaries.

Also read: Can AI End Cancer And Alzheimer’s? Anthropic CEO Dario Amodei Predicts ‘Age Of Miracles’ Within A Decade

How Does The New Blood Test Work?

The researchers found that women with STIC had elevated levels of Tu-Stroma, an RNA molecule related to interactions between abnormal cells and surrounding healthy tissue.

The molecule is linked to a process in which cancer cells weaken neighbouring healthy cells, creating an environment that allows abnormal cells to thrive.

By measuring Tu-Stroma in blood samples, researchers investigated whether this molecular signal could identify STIC before invasive cancer develops.

In a separate validation group, the test detected STIC in 92.3% of women who had the precancerous condition and correctly identified 98.2% of healthy women.

Researchers also modelled how the test might perform in a population of women with inherited risk factors for ovarian cancer. They estimated that approximately 72% of positive results would be accurate, while a negative result would be correct nearly 100% of the time.

Also read: Why Lobular Breast Cancer Can Be Difficult To Detect On A Mammogram?

Could The Test Help Women With BRCA1 And BRCA2 Mutations?

The findings may be relevant to women carrying inherited mutations in the BRCA1 and BRCA2 genes, which increase the risk of ovarian and breast cancers significantly.

Women with these mutations may be advised to consider surgery to remove of their fallopian tubes and ovaries. While this can reduce ovarian cancer risk, it also has consequences like including the loss of fertility and the possibility of early menopause.

Dr Esha Madan, co-author of the study and a researcher at Hoag Family Cancer Institute, said, “For women at high risk, this could transform how we approach prevention.”

She added, “Today, decisions about preventive surgery are largely guided by inherited risk, without knowing whether precancerous lesions are actually present. Our discovery could eventually provide that missing biological information.”

Also read: National Cancer Awareness Day: Diagnosed With Cancer In Your 20s Or 30s? What To Know About Fertility

Can This Blood Test Be Used For Ovarian Cancer Screening?

The study analysed previously collected blood samples from women whose diagnoses were already known. It did not test the blood marker prospectively in a large population of women undergoing routine screening.

The test performed well in samples from people with confirmed conditions and may not achieve the same accuracy in the general population.

Researchers are now planning prospective studies involving women with and without inherited risk factors. These studies will assess whether Tu-Stroma can identify precancerous changes before they progress and whether the results can shape clinical decisions.

Dr Rajan Gogna, who led the research, said, “We asked a fundamentally different question: What if we could identify the earliest molecular warning signs before invasive cancer even develops?”

The discovery offers a new direction for ovarian cancer detection, shifting the focus from finding an existing tumour to identifying biological changes that may precede it.

Long known to be a key risk factor for lungs and heart, a new study now shows that long-term exposure to air pollution and fine particulate matter (PM2.5) may increase the risk of developing type 2 diabetes by 16%.

A rise of 10 micrograms per cubic metre in PM2.5 concentration was associated with a 10% to 16% increase in diabetes risk.

The findings come amid rising pollution levels in Delhi, highlighting the potential metabolic health consequences of prolonged exposure to poor air quality.

Published in the Journal of Vascular Diseases, the analysis found that air pollution is not just a cardiopulmonary concern but also a potential contributor to metabolic health problems.

What Did The Study Find?

The researchers analysed 13 major previous reviews, covering more than 200 million participant observations worldwide.

Reviews examining new diabetes cases consistently found an association between air pollution exposure and a higher risk of developing the disease.

The studies also reported higher diabetes prevalence, elevated blood sugar levels and an increased burden of related health complications.

The association was observed even among populations living in areas classified as having clean air. Since nearly everyone is exposed to outdoor air pollution, even relatively small increases in individual risk could translate into millions of additional diabetes cases worldwide.

South and East Asia are among the regions likely to face a particularly high burden.

Air Pollution Must Be Part Of Diabetes Prevention

Dr. Anoop Misra, Padma Shri, Executive Chairman and Director, Diabetes and Endocrinology, Fortis C-Doc Hospital for Diabetes and Allied Sciences, said air pollution should be recognised as a potential contributor to metabolic disorders, including diabetes, rather than viewed only as a respiratory and environmental concern.

“Air quality management must become a core part of diabetes prevention,” he said.

He also highlighted the growing public health burden in heavily polluted South Asian cities and stressed the need to integrate air quality management into diabetes prevention.

Yashendra Sethi, first author of the study, said India must focus on improving environmental conditions to protect metabolic health.

“If India wants to tackle both diabetes and pollution, we must improve metabolic health and clean up our environment. We cannot fight diabetes while ignoring the air we breathe,” Sethi said.

The researchers emphasised that diabetes prevention should be considered alongside heart and lung health when framing clean-air guidelines.

They recommended strengthening continuous air quality monitoring, tightening emissions standards and incorporating environmental factors into national healthcare policies.

Delhi Air Quality In Very Poor Category

Delhi's air quality slipped into the 'very poor' category on November 11, with the 24-hour average Air Quality Index (AQI) settling at 313. This came a day after stronger winds brought some relief, pushing the AQI into the 'poor' category.

According to the Air Quality Early Warning System (EWS) for Delhi, PM2.5 and PM10 concentrations are also expected to rise over the next two days.

Of the 58 monitoring stations that recorded data on Wednesday, one reported 'severe' air quality, 34 were in the 'very poor' category, 22 in the 'poor' category and one in the 'moderate' category.

Weeks after revealing that she had been wrongly diagnosed with multiple sclerosis (MS), Emmy-winning actor Christina Applegate is exploring whether breast implant illness could explain her chronic pain and fatigue.

Applegate has been experiencing persistent pain and fatigue, which have also affected her mobility. She gradually withdrew from public life after her MS diagnosis in 2021, as she navigated the physical and emotional toll of the condition.

However, in October, the 54-year-old actor revealed that a doctor had told her she did not have MS. She is now undergoing tests for various conditions, including autoimmune diseases and Lyme disease, to determine the cause of her debilitating symptoms.

Applegate is also considering whether her breast implants could be contributing to her health problems. Speaking on the November 10 episode of her podcast, she said her suspicions were reinforced after someone sent her a study that described breast implant illness as "presenting as MS", USA Today reported.

"I swear, over the last five years I thought, 'What if they're leaking and they're poisoning me?'" Applegate said. "So that's one that I will be looking into, because it's something I've thought about."

Christina Applegate Opens Up About Her Symptoms

Also read: Christina Applegate Reveals Multiple Sclerosis Misdiagnosis: Why The Disease Is Hard To Diagnose

Applegate said she is struggling to understand what is causing her persistent pain and fatigue, describing how the symptoms have affected her mobility.

"I'm trying to figure out what's wrong with me; of course I know about these things," she said, referring to the messages she receives from people suggesting possible diagnoses.

She added that the number of possible explanations had become overwhelming.

"It's overwhelming because there's so many different things that could be going on, and this pain stuff – I don't know what's going on in my joints, but I can't move my right shoulder at all now. I can't lift my arm," she said.

In an earlier podcast episode in October, Applegate spoke emotionally about the uncertainty surrounding her health after learning that she did not have MS.

"I'm back at square one – that I don't know what's going on with me," she said.

Despite the news, Applegate said her symptoms have not improved.

“I haven’t gotten better. I still have to use wheelchairs when I go to the doctor’s office. I can’t walk from the car to the room. I’m still in this. Nothing magical happened when she said, ‘You don’t have MS.’ Nothing magical happened.”

Christina Applegate's Breast Cancer And Implant History

Applegate was diagnosed with early-stage breast cancer in 2008 and underwent a double mastectomy, followed by breast reconstruction.

She also discovered that she carries a BRCA1 gene mutation, which increases the risk of developing breast and ovarian cancers.

The actor has previously spoken about her breast implants, saying she was "way overdue for having [the implants] replaced."

What Is Breast Implant Illness?

Breast implant illness (BII) is a term used to describe a range of systemic symptoms that some people report experiencing after receiving breast implants.

The US Food and Drug Administration (FDA) has highlighted several potential complications associated with breast implants, including capsular contracture, implant rupture, certain cancers and symptoms collectively described as breast implant illness.

Reported BII symptoms include:

• Persistent fatigue
• Memory and concentration problems, often described as brain fog
• Joint and muscle pain
• Hair loss
• Weight changes
• Anxiety and depression

However, BII is not a formally recognised medical diagnosis. The FDA notes that there are no specific tests or established diagnostic criteria to define or identify the condition.

While some people report improvements in symptoms after implant removal, the relationship between breast implants and these systemic symptoms remains an area of ongoing research. Applegate's concerns about a possible connection with her symptoms have not yet been medically established.