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.

Research shows that there are an estimated 300 to 450 living supercentenarians—people aged 110 or older—around the world at any given time. Japan is particularly known for healthy ageing, with an average life expectancy of over 84 years and nearly 100,000 centenarians.

While maintaining a healthy and balanced lifestyle may partly explain their longevity, a new study by a A team of Japanese scientists suggests that it may also be linked to an abundance of cancer-fighting immune cells.

The human immune system has specialized cells called CD4 cytotoxic T lymphocytes (CD4 CTLs), which have been shown to kill tumor cells in some cancers.

When a person gets sick, these cells multiply through a process called clonal expansion to help fight infection.

The study, published in the journal Cell Reports, showed that these immune cells may also play a role in healthy ageing among supercentenarians.

“Immune aging is not simply a process of decline,” said first author Kosuke Hashimoto, an associate professor at the University of Osaka in Japan.

“The selective expansion of certain T cells suggests that, even in extreme old age, the immune system may continue to adapt to age-related challenges,” Hashimoto added.

How Do Immune Cells Work In Supercentenarians?

CD4 CTLs are a cellular signature of supercentenarians—people who live to age 110 and beyond. The researchers discovered that these cells expand and adapt within this older population.

“CD4 CTLs are an atypical and relatively rare T cell population,” Hashimoto said. “So, their marked increase in supercentenarians may provide important clues as to how the immune system is maintained in extreme old age.”

What Did the Study Find?

The small study analyzed blood samples from 28 adults divided into three age groups:

• 70–99
• 100–109
• 110 and older

The findings showed that the proportion of CD4 CTLs increased with age, with median percentages of 4%, 9.6% and 17.6%, respectively.

Researchers found that older adults may be responding to persistent immune threats. As a result, CD4 CTLs clone themselves when the immune system is under attack.

The most prominent clone accounted for an average of 33.3% of CD4 CTLs, indicating that older adults may be responding to persistent immune threats. In one centenarian’s blood sample, a single clone accounted for 53.8% of their CD4 CTLs.

Next, researchers matched the receptor sequences of each participant’s top CD4 CTL clone with those in a public database. Nearly three dozen matches belonged to people with cancer, namely lung, breast and liver cancers.

Because none of the centenarians or supercentenarians studied had been diagnosed with these cancers, researchers theorized that their CD4 CTL expansion may reflect early immune responses.

“Some CD4 CTLs may recognize cancer-related targets, although their exact targets remain unknown,” Hashimoto said.

Evidence Remains Preliminary

The study, which focused on T cells circulating in the blood, does not prove that having an abundance of CD4 CTLs prevents cancer or causes a person to live longer.

Hashimoto said the team’s next step is to research how these cells behave in human tissues.

“As we age, abnormal cells, including senescent and cancerous cells, become more common,” Hashimoto said. “Our findings suggest that immune adaptation to these changes may contribute to exceptional longevity.”

Health officials in the US are warning consumers about yet another multistate outbreak of Salmonella and E. coli infections. This time its linked to alfalfa sprouts, which have sickened more than 40 people.

The outbreak comes as the US is also witnessing a major rise in Cyclospora infections, which can cause severe diarrhea. Federal health officials have posted 20 foodborne illness investigations so far this year, with about 10,500 illnesses associated with outbreaks.

Which States Are Reporting Cases?

Minnesota and Wisconsin have reported more than 40 illnesses linked to alfalfa sprouts.

Officials said additional illnesses are being identified in other states, and the number of cases could increase as the investigation continues.

Minnesota

The Minnesota Department of Health and Minnesota Department of Agriculture said 23 Minnesotans became ill between July 8 and August 8 with Salmonella and/or Shiga toxin-producing E. coli (STEC) infections.

Two people have been hospitalized, and no deaths have been reported.

Of the cases, three people had Salmonella, including one who also had STEC O168:H8. Seven people were infected with STEC O103:H25, while 13 had STEC O26:H11.

According to officials, Minnesota reports approximately 1,000 Salmonella infections and 85 STEC infections with the serogroups associated with this outbreak each year.

Wisconsin

Officials in Wisconsin have identified 17 cases, with one person hospitalized.

The Wisconsin cases are connected to a multistate outbreak of STEC and Salmonella infections linked to alfalfa sprouts distributed to restaurants and grocery stores.

Approximately 1,000 Salmonella infections and 500 STEC infections are reported each year in Wisconsin.

Which Alfalfa Sprout Brands Are Linked To The Outbreak?

The illnesses have been linked to alfalfa sprouts produced by Everything Sprouts, a Minnesota grower, and sold under the Calco and Everything Sprouts brands to restaurants and grocery stores.

Health officials recommend checking homes for these products, not eating them and throwing them away.

What Are The Symptoms Of E. Coli Infection?

Shiga toxin-producing Escherichia coli (STEC) is a group of bacteria that make dangerous poisons called Shiga toxins. While most E. coli are harmless, STEC infections can cause:

• Stomach cramps
• Diarrhea, often with bloody stools
• Low-grade or no fever

People usually become sick two to five days after swallowing the bacteria.

Most people recover within five to seven days.

However, STEC infections can also cause hemolytic uremic syndrome (HUS), a severe complication that can lead to acute kidney failure and other serious health problems.

The officials warned that diarrhea caused by STEC infections generally should not be treated with antibiotics, as this can increase the risk of HUS. Anyone who believes they may have an STEC infection should contact a healthcare provider.

What Are The Symptoms Of Salmonella Infection?

Salmonella is a bacterial infection that commonly causes diarrhea and gastrointestinal illness.

Salmonella infection can cause:

• Diarrhea
• Abdominal pain
• Fever

Symptoms usually begin six hours to six days after swallowing the bacteria.

Most people recover from Salmonella infection without medical treatment. However, children, older adults and people with weakened immune systems may develop serious illness requiring medical care.

How To Stay Safe?

Officials advise people to:

• Check their homes for alfalfa sprouts from Everything Sprouts and Calco.
• Do not eat the sprouts.
• Throw them away.
• Anyone who has eaten the sprouts should monitor for symptoms of Salmonella or STEC infection.
• Contact a healthcare provider if symptoms become severe.

American Olympic bronze medallist Jenny Simpson has announced her diagnosis of Arrhythmogenic ‌Right Ventricular Cardiomyopathy (ARVC) -- a rare inherited heart condition that is forcing her to give up her career as it makes running dangerous.

The 39-year-old, former 1500 meters world champion, was diagnosed after collapsing in June ⁠at a community track event hosted by Sir Walter Running and required CPR.

What Happened To Jenny Simpson?

After receiving lifesaving care at the track event, Simpson was transferred to Duke University Hospital for more advanced heart failure support.

Her heart was not pumping strongly enough, causing fluid to build up in her lungs. She described the experience as beginning to “drown.”

“My body was dying, but my spirit wouldn’t give up,” her post read. “I fought for my life.”

Within days, however, her heart and lungs were strong enough to function on their own.

Simpson Forced To End Her Career

Simpson said her diagnosis means “it would be dangerous for me to return to running.” She retired from elite racing in 2024 and described the diagnosis as the end of that chapter of her life.

"I was diagnosed with a rare inherited heart condition, Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)... My future is an incredible gift. It is hopeful, and it will continue to have a ‌great ⁠purpose. But my diagnosis also means it would be dangerous for me to return to running," Simpson said in a post on Instagram.

“That chapter has ended,” the post read. “Thankfully, my story hasn’t.”

Why Can ARVC Be Dangerous?

Simpson was diagnosed with ARVC, a rare inherited condition in which scar tissue in the heart can disrupt its electrical system and trigger dangerous heart rhythms.

The condition can weaken the heart muscle and affect its ability to pump blood effectively. It can affect one or both ventricles; when it mainly affects the right ventricle, it is called ARVC. In Simpson’s case, the abnormal heart rhythms ultimately caused her heart to stop.

“As devastating as that diagnosis sounds, I truly feel profoundly fortunate. CPR, AED shocks, exceptional medical care, and a healthy body and fighting spirit that have spent a lifetime adapting to hard things all came together to give me another chance at life.”

Simpson is the only US woman to win a world 1500m title, which she achieved in 2011, and one of two US women to win an Olympic 1500m medal, taking bronze in 2016.

From 2007 through 2019, she finished among the top three in the 1500m, 5000m or 3000m steeplechase at all 13 USA Track and Field Outdoor Championships.

What Is ARVC?

In ARVC, heart muscle cells do not stick together properly, causing scar tissue and weakening the heart muscle. This can affect the heart’s ability to pump blood effectively.

The condition can affect one or both ventricles. When it primarily affects the right ventricle, it is called ARVC.

ARVC: Symptoms

• Heart palpitations
• Lightheadedness
• Fainting
• Shortness of breath
• Abnormal heart rhythms
• Swelling in the ankles, legs or abdomen
• Chest pain or discomfort

ARVC: Diagnosis

Doctors may use several tests to assess the heart, including:

• Cardiac MRI
• ECG
• Exercise test
• Echocardiogram

ARVC: Treatment

There is no cure for ARVC, but treatment can help manage abnormal heart rhythms and reduce complications. Options may include:

• Pacemaker
• ICD
• Cardioversion
• Catheter ablation.