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.

The FDA on Friday revised the safety information for Sarepta Therapeutics’ Duchenne muscular dystrophy gene therapy, Elevidys, adding a boxed warning to alert patients and doctors about the risk of severe liver damage and possible death. This highest-level warning outlines the chance of serious liver injury and acute liver failure in people who receive Elevidys, with both complications carrying the possibility of being fatal.

The agency has also limited the therapy’s use to ambulatory Duchenne patients who are at least 4 years old and have a confirmed mutation in the DMD gene. With these changes, Elevidys is no longer permitted for patients who cannot walk.

What Is Duchenne Muscular Dystrophy?

Duchenne muscular dystrophy (DMD) is a serious inherited condition that leads to steady muscle weakening and loss, affecting boys far more often. It stems from a defect in the dystrophin gene, which prevents the body from making a key protein that protects muscle fibers.

Signs usually show up in early childhood and include trouble walking or climbing, frequent falls and a noticeable waddling walk, according to the Cleveland Clinic.

What Is The Duchenne Gene Therapy?

Gene therapy for Duchenne muscular dystrophy delivers a corrected or shortened form of the dystrophin gene into muscle cells using a modified virus. This allows the cells to produce a working version of the protein. The single intravenous infusion is designed to slow the disease by restoring some dystrophin, with the aim of improving movement and daily functioning. While the FDA has cleared a therapy that creates a reduced “micro-dystrophin,” researchers are still working on ways to provide the full-length gene for potentially stronger results, as noted by the Food and Drug Administration.

What Is Elevidys?

Elevidys is a gene-based treatment designed for Duchenne muscular dystrophy. It is given only once and relies on an adeno-associated virus to carry a modified form of the dystrophin gene into the body. This shorter micro-dystrophin version is meant to take the place of the faulty or absent dystrophin that leads to the condition.

FDA Tightens Duchenne Gene Therapy After Deaths Of Two Teens

The U.S. Food and Drug Administration is tightening control over a Duchenne muscular dystrophy gene therapy after two teenagers died from liver failure linked to the treatment. The agency has restricted Elevidys, made by Sarepta Therapeutics, to boys aged 4 and older who are still able to walk.

It can no longer be given to boys who have already lost the ability to move independently, something that usually occurs around age 12 in Duchenne. A safety review confirmed that both teenagers developed severe liver damage after receiving the infusion and later died.

The FDA is also adding its strongest boxed warning to call attention to the risks of serious liver injury, acute liver failure and death. Sarepta, based in Cambridge, Massachusetts, with offices in several countries, told regulators earlier this year that it had already stopped supplying the therapy to non-ambulatory patients. The company stated that Elevidys has been used in 1,100 patients worldwide.

These updates “will ensure that families and health-care professionals have clear information” to support treatment choices, Louise Rodino-Klapac, Sarepta’s head of research and development, told The New York Times.

The FDA’s new label comes at the end of a difficult year for Sarepta, marked by weak clinical trial results, safety questions surrounding Elevidys and declining sales.

Liev Schreiber, American actor, best known for his role in Spotlight, and latest seen at the Stranger Things promotional events alongside his daughter Kai Schreiber, was rushed to hospital on Sunday. The actor said that he was suffering from a "brutal headache".

The TMZ reported the health scare after he was being hospitalized in the New York City, and stayed overnight Sunday in the hospital on the advice of his doctor. The doctors have also run tests on him. However, his diagnosis still remains unclear, though as per the TMZ report, doctors have said to him that his ability to walk and speech has not be affected.

Liev Schreiber Health Scare In Past

In April 2024, Schreiber revealed that he had a rare condition called transient global amnesia, while he was starring in Doubt: A Parable on Broadway during an appearance on Late Night with Seth Meyers.

“The worst nightmare that an actor could possibly ever experience. I was in my dressing room and I had a terrible headache. I thought it was maybe a fast-food headache, but it felt a little stronger than that. I am walking down the stairs, and I am thinking, 'This is not normal. I don't feel okay'," he said.

He said that his condition got worse when he was on stage, as he would completely forget his lines. "It all vanishes. The play is gone from my head...I know I am in a play, but I do not know what play I am in," he said.

He added, "My doctor, who’s a friend, shows up, and he had a terrified expression. My wife shows up, and she looks terrified. I think, ‘Okay, I’ve had a stroke. This is it.'” Although it was not a stroke, but the symptom of transient global amnesia, the actor did not believe it.

He recalled the doctor telling him that he may have the same experience again "it will be gone in 8 to 24 hours", however, he did not believe it. "You know, as a typical sort of Jewish hypochondriac person, I’m convinced that I had a stroke and they just didn’t find it," he said.

“I go to sleep, I wake up, I remember the whole play. I never had another problem with it. I was embarrassed and thought everyone would think I was lying and taking a night off from the theater,” he added.

What Is Transient Global Amnesia?

Transient Global Amnesia or TGA is a sudden, temporary episode of confusion and memory loss, where a person cannot form new memories (anterograde amnesia) and may have trouble recalling recent past events (retrograde amnesia).

Individuals with TGA often repeatedly ask the same questions because they forget the answers, but they retain their sense of self and recognize close friends and family. Episodes are usually benign, resolve within 24 hours, and do not result in lasting neurological damage.

While the cause of transient global amnesia is not known, experts believe that there could be a link between TGA and a history of migraines. However, the factors that contribute in the link of these two conditions are still not fully understood.

Common Signs Of Transient Global Amnesia

• Sudden onset of confusion and memory loss
• Inability to form new memories
• Repetitive questioning about their situation
• Disorientation regarding their location and recent events
• Retention of personal identity and recognition of familiar people
• Preserved ability to perform complex tasks, language, and other cognitive functions

Ethiopia has confirmed its first Marburg Virus outbreak after reports began to circulate from last week. The reports showed cases of a viral hemorrhagic fever in the southern part of the country, as confirmed by the World Health Organization (WHO).

As of now, 16 cases have been identified in the region of Jinka city in the south, and 129 additional case contacts are being monitored. The Ethiopian Ministry of Health have also confirmed that three people have died

"Genetic analysis by the Ethiopia Public Health Institute revealed that the virus is of the same strain as the one that has been reported in previous outbreaks in other countries in East Africa. A total of nine cases have been reported in the outbreak that has affected Jinka town in the South Ethiopia Region," the WHO said.

What Is Marburg Virus?

With the fatality rate of 8% it is the same virus family as Ebola. The main carrier is from fruit bats which spreads to humans then through the contact of bodily fluids of infected individuals, it spreads to others.

As per the WHO, this virus is capable of killing half of the people it infects. This was for the first time detected in 1976 after 31 people were infected. Out of them, seven died in simultaneous outbreak in Marburg and Frankfurt in Germany, and in Belgrade in Serbia. The virus is also named after the location it was first detected.

The source was traced to African green monkeys who were imported from Uganda. However, other animals too are linked to the virus spread, including bats.

In the past, the virus outbreaks have happened in countries like Equatorial Guinea, Ghana, the Democratic Republic of the Congo, Kenya, South Africa, Uganda, Zimbabwe, and Rwanda. In 2005, this virus killed 300 people in Angola.

Last year in Rwanda, Marburg killed 15 people, and affected at least 66 people.

Read: Marburg Virus Outbreak In Rwanda

However, for the rest of the world, only two people have died from the virus in the rest of the world, with one of them being in Europe, and the other in the US. These both have been on expeditions to caves in Uganda.

What Are The Common Signs And Symptoms Of Marburg Virus?

The common signs and symptoms of the Marburg virus include fever, pain, diarrhoea, vomiting and in the case of extreme blood loss, death too can happen.

So far, there is no specific treatment or vaccine for the virus. However, treatments like drugs and immune therapy are being developed as per the World Health Organisation (WHO).

No Vaccine For Marburg

While it may have the similar fatality rate, but unlike Ebola, there is no vaccine against Marburg. On X, WHO Director-General Tedros Adhanom Ghebreyesus said he commended Ethiopia for its "rapid and transparent response to the outbreak, and the work of the Ethiopia Public Health Institute and regional health authorities. This fast action demonstrates the seriousness of the country's commitment to bringing the outbreak under control quickly."