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.

Women with autoimmune diseases are more likely than men to get told that their symptoms were merely psychological, resulting in longer delays and timely treatment.

A new international study published in The Lancet’s eClinicalMedicine studied the diagnostic experiences of 6,607 people living with autoimmune diseases.

Researchers from the University of Cambridge and the University of East Anglia found that 43% of women reported that their symptoms had previously been attributed to psychiatric causes, compared to 33% of men.

Women were also more likely to report being told their physical symptoms were psychosomatic, meaning they were caused by psychological factors. This was reported by 34% of women, compared to 22% of men.

After accounting for factors like age, disease group, continent and household finances, women were nearly 50% more likely to report a psychiatric misdiagnosis and almost 75% more likely to report a psychosomatic misdiagnosis than men.

The findings highlight gender disparities patients with autoimmune conditions experience during the diagnostic process, especially when the condition is not immediately ascertainable through clinical tests.

Women Report Longer Delays In Diagnosis

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The study also found differences in how long patients waited between the onset of symptoms and receiving an autoimmune disease diagnosis.

Among women, the most frequently reported time to diagnosis was one to two years. For men, the most common interval was less than three months. Women also reported attending more healthcare consultations before receiving a diagnosis.

“Patients with autoimmune diseases can present with symptoms that can initially be difficult to explain medically, and sometimes it can take months or years before a diagnosis becomes clear,” said Dr Melanie Sloan, from the University of Cambridge and the University of East Anglia.

“Our findings highlight that psychological or mental health explanations can be given too soon. This is true for both sexes, but our study suggests that females may be particularly vulnerable to these types of misdiagnoses,” she added.

Autoimmune diseases develop when the immune system mistakenly attacks the body's own tissues. For example, conditions like lupus, rheumatoid arthritis and multiple sclerosis. Statistically, women are more likely to develop autoimmune diseases than men.

Diagnosis can be challenging because early symptoms may include fatigue, persistent pain, sleep disturbances and low mood. These symptoms are common in other conditions, may fluctuate over time and can affect multiple parts of the body.

Patient Accounts As Important As Medical Records

The researchers said that patient accounts are important because medical records may not capture the full diagnostic journey, including when symptoms first appeared or how patients experienced consultations.

Shaista Tayabali, a patient partner and co-author of the study, said, “The differences between the sexes in misdiagnoses for people with autoimmune diseases is stark. The fact that females reported higher rates of psychiatric and psychosomatic misdiagnoses than males, yet reported lower misdiagnoses for other physical diseases, suggests that historical gender biases remain a challenging aspect of the diagnostic journey.”

The researchers stressed that the findings do not mean psychological diagnoses are always incorrect. People can have both autoimmune and mental health conditions, and some autoimmune diseases, including lupus, can themselves affect the brain.

The team called for clinicians to remain alert to possible autoimmune conditions, acknowledge diagnostic uncertainty and reassess patients when symptoms persist.

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.

Spain is seeing a rise in COVID-19 cases as the XFG variant, also known as American COVID, becomes the dominant circulating strain. Acute respiratory infections have reached epidemic levels, with COVID-19 and bronchiolitis contributing to the increase.

The Carlos III Institute’s Acute Respiratory Infection Surveillance System (SiVIRA) recorded 493.8 cases per 100,000 people between September 28 and October 4, up 3.3% from 478.2 the previous week.

According to Redacción Médica, infection intensity remains low despite the upward trend. COVID-19 incidence alone approached 120 cases per 100,000 people.

XFG Dominates COVID-19 Cases In Spain

The European Centre for Disease Prevention and Control (ECDC) estimated that XFG accounted for 54% of sequences reported by countries with sufficient data during weeks 34 and 35.

In Spain, the variant represented around 69% of those identified in primary care and 65% of hospital samples. However, the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) cautioned that the rise cannot be attributed to XFG alone.

Spain is also witnessing a rise in respiratory viruses, which reached 478.2 cases per 100,000 inhabitants between 21 and 27 September, well above the 373 the previous week and also above the 400 mark, which marks the start of an epidemic.

Estimates put the total incidence of Covid-19 at 119.2 cases, compared with 92.6 in the previous week. The rate of positive test results stands at 4.1 per cent for flu, 27.2 per cent for SARS-CoV-2 and 0.2 per cent for respiratory syncytial virus (RSV), which causes bronchiolitis.

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What Is The XFG Variant?

XFG is a recombinant Omicron lineage formed when two Omicron sublineages combined. The World Health Organization (WHO) classified it as a variant under monitoring in 2025 because of its growth advantage. It is not a variant of concern yet.

Although XFG has mutations in its spike protein, studies suggest its ability to evade immunity differs only slightly from that of other JN.1 descendants.

There is no evidence that XFG causes more severe illness than other circulating Omicron variants. However, increased transmission can still lead to more hospital admissions by raising the total number of infections.

XFG Symptoms

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XFG has no distinctive symptoms that reliably separate it from other COVID-19 variants. Common symptoms include:

• Sore throat
• Runny or blocked nose
• Cough
• Fever or chills
• Headache and muscle aches
• Fatigue

Loss of smell or taste is less common than during the early pandemic. Symptoms alone cannot identify the variant causing an infection.

Why Are Cases Rising?

The Institute reported that possible contributors to rising infections include:

• Greater transmissibility of XFG
• Waning immunity from vaccination and previous infections
• Increased social contact after summer
• Seasonal patterns of recurring COVID-19 waves
• Multiple sublineages circulating simultaneously

The relative contribution of each factor remains uncertain.

COVID-19 Cases Rise In The UK And France

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United Kingdom: The UK Health and Security Agency recorded a staggering 230% jump in cases from August to September, rising from 1,374 to 4,589. Hospital admissions soared even more dramatically from 950 to 4,939 in the same period.

The National Health Service (NHS) advises calling 999 for medical emergencies, including severe breathing difficulties, coughing up blood, collapse, loss of consciousness or a first seizure. The agency has also advised Brits testing positive to isolate for at least five days, with under-18s needing just three days. Anyone with the virus should avoid contact with immunocompromised people for 10 days.

France: COVID-19 cases among people consulting general practitioners for acute respiratory infections in France reached 13 per 100,000 during September 21–27, up from nine the previous week, The Connexion reported.

This represented approximately 8,806 cases, compared with around 6,000 a week earlier.

Overall, acute respiratory infections reported by general practitioners rose from 103 to 151 cases per 100,000 people. Rhinoviruses accounted for 40% of samples, compared with 10% for COVID-19.