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 46-year-old mother of six in Oregon, US, lost both legs and suffered multiple life-altering injuries after developing a severe infection following a hysterectomy.

According to a lawsuit alleging medical negligence, Trisha Stevens underwent the hysterectomy in October 2024. The lawsuit alleges that her infection was not diagnosed on time and treated promptly, which eventually led to peritonitis, septic shock and multiple organ failure.

Stevens and her husband are seeking $68.5 million in damages from several doctors and Legacy Health. The allegations have not been established in court yet.

Stevens lost both legs above the knees, her right hand and parts of her left hand. She also lost parts of her lips and tongue and suffered spinal cord damage that left her paralysed from the waist down.

“I came home having lost both of my legs and my right hand. My left hand was left unusable after the necrosis. I lost parts of my lips and tongue, and I live with paralysis in a body that no longer responds the way it once did,” Stevens told local news outlet KGW.

Her husband, Brian, now cares for her as she navigates the physical, mental and emotional consequences of the sepsis.

What Is Sepsis?

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Sepsis is a life-threatening medical emergency that occurs when the body's response to an infection gets dysregulated, damaging its own tissues and organs. It can develop from infections affecting the lungs, urinary tract, skin or gastrointestinal system, as well as infections after a surgery.

Without timely treatment, sepsis can progress to organ failure and death. In severe cases, it can cause septic shock, in which blood pressure falls dangerously low and organs receive insufficient blood flow.

Stevens' case involved peritonitis, an inflammation of the tissue lining the abdominal cavity, followed by septic shock, according to the lawsuit.

Severe infection and septic shock can disrupt blood circulation and reduce oxygen delivery to tissues. When blood flow becomes critically inadequate, tissue can die, which is known as necrosis. In some cases, surgeons may need to amputate affected limbs to remove dead or severely damaged tissue and prevent further complications.

However, limb loss is not an inevitable outcome of sepsis. It represents a severe complication that can occur in some critically ill patients.

Warning Signs

The US Centers for Disease Control and Prevention identifies several possible signs of sepsis:

• Fever, shivering or feeling unusually cold
• Confusion or disorientation
• Rapid heart rate or a weak pulse
• Shortness of breath
• Clammy or sweaty skin
• Extreme pain or discomfort

After surgery, worsening abdominal pain, fever, unusual bleeding, wound discharge or a sudden deterioration in general health warrants urgent medical assessment. Symptoms should not be dismissed simply because a patient has recently undergone a procedure.

Sepsis requires immediate evaluation and treatment. Management may include antibiotics, intravenous fluids, support for organ function and, where necessary, surgery to control the source of infection.

Actor and disability rights advocate RJ Mitte, best known for his performance in Breaking Bad, has died aged 34. His representative confirmed the news of his passing.

"It is with profound sadness that we share the tragic passing of beloved actor, philanthropist, and passionate disability rights advocate RJ Mitte," his representative told the BBC.

He was found at his home in Brownsville, Texas at 12:50 pm. The cause of his death is yet to be determined, although authorities are suspecting it to be suicide. They are investigating the circumstances surrounding his death.

According to the Brownsville Police Department, "The cause and manner of death are still pending, as there is currently an ongoing investigation."

'Breaking Bad' Co-Star Bryan Cranston Says 'Seek Help'

Mitte, who lived with cerebral palsy, parlayed his own experience into his character, Walter 'Flynn' White Jr in the Emmy-winning drama series, starring Bryan Cranston, Aaron Paul, and Anna Gunn.

Cranston took to Instagram to share a heartfelt note about Mitte, sharing their experiences of working together. He wrote, "Born with Cerebral Palsy, he never - ever - allowed that challenge to be an excuse for anything. He met the demanding shooting schedule head on with great determination."

He added, "He parlayed his experience on the show to be a vocal advocate for performers with disabilities, and was the head of a philanthropic organization with a focus on helping the disabled community." Cranston's post contributed to the speculation that Mitte took his own life.

He also added a note for those who are struggling: "I can’t stop there without imploring anyone who is contemplating suicide to please call for the support you need at 988 Suicide & Crisis Lifeline (https://988lifeline.org/). There is hope."

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RJ Mitte's Life With Cerebral Palsy

Mitte was diagnosed with a relatively mild form of cerebral palsy as a young child. Unlike his character in Breaking Bad, who uses crutches and has noticeably slurred speech, Mitte did not require crutches to function in his real life.

This illustrates a key point about cerebral palsy. The disease affects people differently, and its visible signs and severity can vary considerably as one ages.

According to the CDC, cerebral palsy is a group of lifelong neurological conditions caused by abnormal development or damage to the developing brain. It affects movement, muscle control, balance, and posture. It is marked by impaired motor coordination and affects one in 323 children in the United States.

Mitte was the ambassador for United Cerebral Palsy and Shriners Children's. Mitte's representative Sean Reilly told BBC, "Mitte brought authenticity to the role and built a platform on disability awareness and inclusion."

Mitte was known for his extensive efforts to expand representation for people with disabilities. He also created The Mitte Foundation as well, to support philanthropic efforts and community initiatives, using his platform "to challenge stereotypes and promote greater representation for people with disabilities", Reilly said.

In addition to battling physical challenges related to the disease, Mitte also shed awareness about the bullying children with similar disabilities often face.

In an interview with Brain Health, Mitte said, "I was verbally harassed, knocked down, and even had my hand broken," Mitte says. "Having CP made me a target for bullies, and I learned that kids with disabilities are twice as likely to be bullied as other kids."

Bristol Myers Squibb’s experimental drug admilparant has shown promise in a late-stage clinical trial involving people with idiopathic pulmonary fibrosis (IPF), a progressive lung disease that causes irreversible scarring and gradually worsens breathlessness.

The pharmaceutical company announced on October 12 that the lower dose of the drug significantly slowed the decline in lung function compared to a placebo over 52 weeks. However, the higher dose did not meet the trial’s primary goal, raising questions about the treatment’s effects subject to dosage.

The Phase 3 ALOFT-IPF trial enrolled 1,255 patients and evaluated two doses of admilparant, 60 mg and 120 mg, taken twice daily. The study compared both doses with a placebo. Its primary goal was measuring changes in forced vital capacity (FVC) from the start of treatment to Week 52.

FVC measures the amount of air a person can forcefully exhale after taking a deep breath. A decline in this measure can indicate worsening lung function.

According to Bristol Myers Squibb, the 60 mg dose demonstrated a statistically significant benefit over placebo. The 120 mg dose also slowed the decline in lung function, but the difference did not reach statistical significance.

The company said the drug was generally well tolerated at both doses. Also, the treatment discontinuation due to adverse events remained low compared to placebo. Detailed trial results are yet to be presented.

What Is Idiopathic Pulmonary Fibrosis?

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IPF is a chronic lung disease in which lung tissue becomes progressively scarred and stiff. As the scarring advances, the lungs become less efficient at transferring oxygen into the bloodstream, making everyday activities increasingly difficult.

The disease is described as idiopathic because its precise cause is unknown. Symptoms commonly include persistent breathlessness, a dry cough and fatigue. The condition can progress unpredictably, and the damage caused by fibrosis is generally irreversible.

Existing antifibrotic treatments can slow the loss of lung function, but they do not eliminate established scarring or cure the disease. This leaves a need for additional treatments that can delay progression.

About Admilparant

Admilparant, also known as BMS-986278, is an oral drug designed to block the lysophosphatidic acid receptor 1 (LPA1).

The LPA1 signalling pathway is involved in processes linked to pulmonary fibrosis, including inflammation, tissue injury and the activation of cells that produce scar tissue. By blocking this receptor, admilparant is intended to interfere with mechanisms that contribute to the progression of lung scarring.

The drug is being investigated as a first-in-class treatment that uses this approach in people with IPF and progressive pulmonary fibrosis.

“IPF remains one of the most complex and challenging lung diseases to treat, with unpredictable progression, irreversible scarring and a profound impact on patients’ daily lives,” said Fernando Martinez, chair of the ALOFT programme’s clinical steering committee and a professor of medicine at UMass Chan Medical School.

“These admilparant results represent an important advancement as there remains a need for therapies that are both effective and tolerable for patients living with IPF,” he added.

Bristol Myers Squibb said it would complete a comprehensive evaluation of the trial data and deal with regulatory authorities for submissions. The detailed findings are expected to be presented at a future meeting.