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.

In a world first, a 15-foot reticulated python named Jodie Foster has successfully undergone electrochemotherapy, a pioneering cancer treatment usually used in humans.

The reticulated python is a species native to South and Southeast Asia. It is the world’s longest snake and the third heaviest.

The 50kg python, named Jodie Foster after the Hollywood star, underwent the treatment after being diagnosed with fibrosarcoma, a malignant tumor, in her jaw. The tumor was initially removed through surgery but later returned and began invading her jawbone.

“Months later, 50kg Jodie Foster is cancer-free and back to her usual ‘bright and feisty’ self,” Chester Zoo in the UK said in a statement.

What Happened To Jodie Foster?

Keepers became concerned when Jodie started eating less and became more inactive. Tests confirmed a fibrosarcoma in her jaw. Vets initially removed the tumor through surgery.

Tests confirmed she had a fibrosarcoma, a malignant tumor, in her jaw. Although vets initially removed the tumor, it later returned and started destroying part of her jawbone. Doctors feared further surgery alone would not be enough and that the tumor could eventually make it difficult for her to eat.

“We were facing the possibility of losing her as the tumor made it more and more difficult for her to eat, so we worked with cancer specialists to see whether we could adapt electrochemotherapy for a snake," said Ian Ashpole, Veterinary Officer at Chester Zoo :

“As far as we're aware, this is the first time it's ever been used in one," Ashpole added.

Also read: Moderna and Merck’s Custom-Made mRNA Cancer Vaccine Shows Promise In Late-Stage Melanoma Trial

How Was The Human Cancer Treatment Adapted For A Snake?

With no operating table large enough for a python of Jodie's size, the veterinary team had to improvise.

For the operation that lasted 90 minutes, Jodie was first anaesthetized in her habitat before being taken to the veterinary center.

Two operating tables were placed together to create a surface roughly the size of a double bed. Heated blankets and warm air were also used to keep her body temperature stable.

Dr. Ashpole first removed the tumor and performed a hemi-mandibulectomy, removing part of the diseased jawbone. Electrochemotherapy was then used to target any remaining cancer cells.

What Is Electrochemotherapy? How Does It Work?

According to Cancer Research UK, electrochemotherapy combines chemotherapy with small electrical pulses.

It is used to treat some cancers that begin in the skin or have spread to the skin. However, its use in Jodie Foster marks a world first in veterinary medicine for a snake.

“Electrochemotherapy is an emerging treatment, and this was the first time it had been used in a snake,” said Jose Alvares Picornell, Department of Small Animal Clinical Science, University of Liverpool, who was part of the three-hour-long surgery.

The treatment combines the cancer drug bleomycin with carefully controlled electrical pulses delivered directly to the tumor site.

• The electrical pulses temporarily make cancer cells more permeable.
• This allows the drug to enter the cells more effectively.
• The approach can allow lower doses of chemotherapy to be used.
• It can sometimes be delivered in a single procedure.

Read More: Microplastics Found In Anchovies’ Edible Muscle: What It Means For Brain Health

Jodie Foster Back 'Bright And Feisty'

Despite losing part of her jawbone, Jodie's appetite and hunting ability have not been affected, the Zoo officials said, adding that she continues to strike, grip and swallow food without difficulty.

Months of observation have shown no problems with feeding, and a final check confirmed that she remains free of signs of the cancer returning. The officials added that Jodie is eating normally, exploring her habitat and behaving as usual.

“Seeing her back to her normal bright and feisty self has been incredibly rewarding. A few months ago, we genuinely didn't know whether she'd survive," Dr Ashpole added.

Delhi is witnessing a significant rise in influenza A H1N1 infections, with the cumulative tally reportedly reaching 1,777.

As per National Centre for Disease Control (NCDC) data, Delhi recorded 1,449 H1N1 cases up to August 12, more than six times the 229 cases reported during the same period last year. Mumbai and Bengaluru are also reporting a sharp rise in cases.

Health Ministry Reviews H1N1 Preparedness

Amid the rise, Union Health Minister JP Nadda reviewed preparedness, including:

• Hospital bed availability
• Critical care facilities
• Essential medical supplies
• Influenza surveillance and epidemiological trends
• ILI and SARI trends
• Testing and laboratory surveillance
• Healthcare facilities’ preparedness

The “situation is being closely and continuously monitored”, said Nadda. The Health Minister also emphasized continued vigilance, robust surveillance and proactive preparedness, along with respiratory and hand hygiene.

People with persistent or severe respiratory symptoms, breathing difficulty or other warning signs were advised to seek medical attention promptly.

The Health Ministry is coordinating with States/UTs, hospitals, laboratories and other stakeholders for early detection, timely clinical management and effective surveillance of seasonal influenza, including H1N1.

Doctors Flag Atypical H1N1 Symptoms

Dr. Atul Kakkar, Senior Consultant and Head of Department, Internal Medicine, Sir Gangaram Hospital, told HealthandMe that H1N1 cases are significantly higher than last year, possibly partly due to seasonal changes.

Most patients are presenting with flu-like symptoms, cold, cough, body aches, and upper respiratory tract infections.

However, doctors are also seeing atypical symptoms.

“We are seeing patients having diarrhea also and myalgias, which are getting very, very frequent.”

Patients at extreme ages are more prone to complications and may require oxygen, high-flow oxygen, NIV or BiPAP, he said.

Those at higher risk include people who are unvaccinated against flu, patients undergoing chemotherapy, and those with COPD, bronchial asthma, cancer or on immunosuppressive treatment.

“Evidence shows early antiviral treatment reduces complications and hospital stay, so we must expand rapid diagnostic capacity across primary care centres and ensure affordable antivirals are available at the point of care,” Dr. Sabine Kapasi, Global Health Strategist and UN Advisor, told HealthandMe.

What Is H1N1?

H1N1 is a subtype of influenza A virus. Common symptoms include:

• Fever
• Cough
• Sore throat
• Runny or blocked nose
• Headache
• Fatigue
• Body aches
• Vomiting or diarrhoea, particularly in some children

The virus mainly spreads through respiratory droplets when an infected person coughs, sneezes or talks.

Children can also spread the virus before they realize they are sick.

Red-flag symptoms include:

• Persistent high fever
• Worsening breathlessness
• Chest pain
• Confusion
• Inability to drink

H1N1 Can Affect The Heart

As per experts, H1N1 infection may also be associated with cardiovascular complications, including:

• Heart inflammation
• Abnormal heartbeats
• Worsening heart failure

Dr. Saurabh Gupta, Associate Director, Internal Medicine, Yashoda Medicity, said H1N1 may cause fluctuations in heart rhythm or inflammation involving the heart.

“Those with pre-existing heart conditions should be more vigilant whilst they’re recuperating. As the infection puts more work on the body, you can find that previous heart problems are more noticeable,” he added.

Warning Signs After H1N1

People recovering from H1N1 should seek medical attention if they develop:

• Severe chest pain
• Shortness of breath
• High or fluttering pulse
• Sudden faintness
• Severe weakness.

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.”