The global challenge of HIV/AIDS remains one of the most pressing public health issues today. According to the latest data from UNAIDS, around 38.4 million people worldwide are living with HIV/AIDS, underlining the need for not only medical intervention but also comprehensive awareness, education, and social change. Despite the significant strides made in treatment and prevention, the confusion surrounding the relationship between HIV and AIDS still persists.

Young people have become influential advocates in the fight against HIV/AIDS. Research from UNICEF shows that youth-led initiatives can lower HIV transmission rates by as much as 45% in targeted communities. These young activists utilize digital platforms and peer-to-peer education to dispel myths, promote safe practices, and foster supportive environments for those affected by HIV/AIDS.

Dr Gowri Kulkarni, an expert in Internal Medicine, explains that while the terms HIV and AIDS are often used interchangeably, they are distinctly different. "HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system, whereas AIDS (Acquired Immunodeficiency Syndrome) is a condition that occurs when HIV severely damages the immune system," she clarifies. To understand the implications of these differences, it's important to explore the fundamental distinctions between the two.

1. HIV is a Virus; AIDS is a Syndrome

HIV is the virus responsible for attacking the body’s immune system, specifically targeting CD4 cells, which are crucial for the body’s defense against infections. As HIV progresses, it destroys these cells, weakening the immune system over time. If left untreated, this continuous damage can lead to AIDS.

AIDS, on the other hand, is a syndrome, not a virus. Dr Kulkarni further elaborates that AIDS is a collection of symptoms and illnesses that emerge when the immune system is severely compromised due to prolonged HIV infection. It represents the most advanced stage of HIV, and is characterized by very low CD4 counts or the onset of opportunistic infections like tuberculosis, pneumonia, or certain cancers.

2. Not Everyone with HIV Develops AIDS

A key distinction to remember is that not everyone with HIV will progress to AIDS. Thanks to advancements in medicine, particularly antiretroviral therapy (ART), individuals living with HIV can manage the virus and maintain a healthy immune system for many years, or even decades, without ever developing AIDS. ART works by suppressing the virus to undetectable levels, effectively preventing the damage HIV would otherwise cause to the immune system.

Without treatment, however, HIV progresses through three stages:

- Acute HIV Infection: This stage occurs shortly after transmission and may include symptoms like fever, fatigue, and swollen lymph nodes.

- Chronic HIV Infection: Often asymptomatic or mildly symptomatic, the virus continues to damage the immune system but at a slower rate.

- AIDS: This is the final stage, marked by severe immune damage and the presence of infections that take advantage of the compromised immune defenses.

3. HIV is Transmissible; AIDS is Not

Another key distinction between HIV and AIDS is the way in which they are transmitted. HIV is highly contagious and can be transmitted through the exchange of bodily fluids such as blood, semen, vaginal fluids, and breast milk. It is primarily spread through unprotected sexual contact, sharing needles, or from mother to child during childbirth or breastfeeding.

AIDS, however, is not transmissible. It is not a disease that can be passed from one person to another. Rather, AIDS is the result of untreated, advanced HIV infection and is a direct consequence of the virus’s damage to the immune system.

4. Diagnosis Methods Differ

HIV and AIDS are diagnosed through different methods. HIV is diagnosed through blood tests or oral swabs that detect the presence of the virus or antibodies produced by the immune system in response to the virus. Early detection of HIV is crucial, as it allows for timely intervention and treatment, which can prevent the virus from progressing to AIDS.

AIDS, on the other hand, is diagnosed using more specific criteria. Dr Kulkarni notes that the diagnosis of AIDS is made when the individual’s CD4 cell count falls below 200 cells/mm³, or when opportunistic infections or certain cancers (such as Kaposi's sarcoma or lymphoma) are detected. Diagnosing AIDS involves a more thorough assessment of the individual’s immune function and overall health, as opposed to just the detection of HIV.

5. Treatment Goals Are Different

The treatment goals for HIV and AIDS differ significantly, although both involve antiretroviral therapy (ART). For HIV, the primary treatment goal is to suppress the virus to undetectable levels, thus maintaining a strong immune system and preventing further transmission of the virus. People living with HIV can often live long, healthy lives if they adhere to ART.

For individuals diagnosed with AIDS, the treatment plan becomes more complex. While ART remains an essential part of managing the virus, treatment for AIDS also focuses on addressing the opportunistic infections and secondary health complications associated with severe immune suppression. The goal of treatment for AIDS is not only to manage the HIV virus but also to improve the quality of life and extend survival by treating these secondary health issues.

Role of Community Engagement in Combatting HIV/AIDS

While the medical community has made great strides in managing HIV, the battle to curb its transmission is also a social and cultural issue. Dr Daman Ahuja, a public health expert, highlights that HIV/AIDS awareness and education are vital to reducing transmission rates and supporting those affected by the virus. "Young people, especially, have become key advocates in the fight against HIV/AIDS," says Dr Ahuja. "Research from UNICEF shows that youth-led initiatives can lower HIV transmission rates by as much as 45% in targeted communities."

Additionally, grassroots activism plays a significant role in raising awareness and addressing stigma. As the World Health Organization reports, community-based interventions have been proven to increase HIV testing rates and improve treatment adherence, which are crucial in the fight against the pandemic.

The ultimate goal of organizations like UNAIDS is to eliminate the HIV/AIDS pandemic by 2030. Achieving this requires global collaboration, from medical treatment advancements to public health strategies, education, and advocacy. Dr Kulkarni’s insight underscores the importance of early detection, treatment adherence, and community support in the fight against HIV/AIDS.

Dr Gowri Kulkarni is Head of Medical Operations at MediBuddy and Dr Daman Ahuja, a public health expert and has been associated with Red Ribbon Express Project of NACO between 2007-12.

Irritable bowel syndrome (IBS) is often characterised by digestive symptoms like abdominal pain, bloating, constipation and diarrhoea. However, the condition involves more than the digestive system.

A new review published in The Lancet explains how interactions between the gut and brain, changes in the gut microbiome, immune activity and the body's response to pain can contribute to the development of symptoms.

The review, titled Irritable bowel syndrome and related disorders of gut-brain interaction, brings focuses on biological and psychological evidence behind IBS. Researchers describe it as a disorder of gut-brain interaction, in which signals between the digestive system and the central nervous system affect gut function.

The authors also discuss chronic constipation and functional diarrhoea, which belong to the bigger group of disorders related to gut-brain interaction. These conditions may affect an estimated 20% of the global population.

What Is The Gut-Brain Connection In IBS?

Also read: Olympian Ciara Mageean Dies At 34 After Bowel Cancer Battle: Warning Signs In Young Adults

The gut and brain communicate continuously through a complex network that involves the central nervous system, autonomic nervous system, enteric nervous system and hypothalamic-pituitary-adrenal (HPA) axis.

The brain can influence intestinal movement, secretion and sensitivity, while signals from the gut can affect how the brain processes pain and other sensations.

In people with IBS, this communication may become disrupted. The result can be changes in bowel movements, more sensitivity to normal digestive processes and abdominal discomfort.

The authors said, “These central and peripheral mechanisms can act in an integrated way to cause IBS symptoms, via the gut-brain axis.”

For instance, a person with IBS may experience pain or bloating even when the amount of gas or intestinal movement would not cause discomfort in someone without the condition. This is due to a condition called visceral hypersensitivity, in which the nerves supplying the digestive organs become unusually sensitive to internal sensations.

The review explains that changes in both peripheral mechanisms within the gut and central mechanisms involving the brain can contribute to symptoms.

Gut Bacteria And Inflammation May Contribute To IBS

Also read: Can Coffee Trigger Irritable Bowel Syndrome?

The gut microbiome, which consists of microorganisms living in the digestive tract, is another important part of the gut-brain connection.

Changes in the composition and activity of gut bacteria may impact intestinal function, immune responses and communication with the nervous system. The review identifies the following:

• Gut infections: Gastrointestinal infections can trigger IBS symptoms in some people, even after the initial infection has subsided.
• Altered gut microbiome: Changes in intestinal bacteria may affect digestion, immune activity and gut function.
• Increased intestinal permeability: Changes in the intestinal barrier may allow substances to pass through more easily, potentially contributing to immune activation.
• Low-grade inflammation: Mild inflammation in the intestinal lining and changes in immune function may contribute to symptoms.
• Abnormal gut movement: Changes in gastrointestinal motility can cause food and waste to move through the digestive tract too quickly or too slowly.
• Visceral hypersensitivity: Increased sensitivity in the gut can make normal digestive processes feel painful.

Mental Health And IBS

Psychological health is another component of the gut-brain axis. Stress, anxiety and other psychological difficulties can influence how the brain processes pain and communicates with the digestive system.

The HPA axis, which helps regulate the body's response to stress, plays a role in this process . Changes in stress levels can affect gut movement, secretion and sensitivity.

Currently, there is no single biomarker that can diagnose IBS. Doctors assess symptoms, medical history and clinical findings, while using tests to rule out other conditions.

The review highlights that some underlying mechanisms can already be measured through approved tests and questionnaires. These include abnormal bile acid metabolism, accelerated movement of contents through the colon and psychological conditions.

Does a patient’s chances of serious outcomes differ if they are treated by a female doctor? A recent study looks into this hypothesis to ascertain the difference between chances of a patient dying under a male and a female doctor.

According to the study, hospitalised patients treated by female doctors have a lower risk of dying within 30 days. They are also less likely to be re-hospitalised than those treated by male doctors. The study is published in JAMA Network Open.

"Past research has largely focused on surgical patients and the admitting physician only. Our findings add to the growing body of research examining the relationship between physician sex and patient outcomes, broadening the evidence beyond surgical care to a wider range of medical conditions and other physicians," says Dr. Angela Jerath, an ICES scientist, and Associate Professor, Department of Anesthesiology & Pain Medicine at the University of Toronto's Temerty Faculty of Medicine.

After analysing the health records of 958,150 adults admitted to hospitals in Ontario, Canada, between 2008 and 2022, researchers found that the 30-day mortality rate was 12.3% among patients treated by female physicians, compared to 13.7% among those treated by male physicians.

The findings also show a small difference in hospital readmissions. The 30-day readmission rate was 18.6% for patients treated by female doctors and 18.9% for those treated by male doctors.

The researchers examined outcomes across seven common medical conditions, including heart attacks, pneumonia and other acute illnesses.

They also considered the number of hospital days during which patients received care from female doctors, recognising that several doctors may be involved in a patient's treatment during an admission.

Patients Treated By Female Doctors Are Less Likely To Die In A 30-Day Period

Also read: Manosphere Is A Public Health Concern: Lancet Report Says Online Misogyny Harms Men's Mental Health

After accounting for patient, physician and hospital characteristics, treatment by a female physician was linked with 12% lower adjusted odds of death within 30 days compared to treatment by a male physician.

The researchers also found that for every 10% increase in the proportion of hospital days managed by female physicians, the adjusted odds of 30-day mortality decreased by 7%. This was observed for most medical conditions that were studied. Atrial fibrillation was the only exception.

The difference in mortality was also seen at longer follow-up periods. Patients treated by female physicians had lower mortality at 90 days and one year.

The findings were observed among both male and female patients. Female patients treated by female physicians had the lowest adjusted 30-day mortality rate in the analysis.

Why Patients May Have Better Outcomes With Female Doctors?

The study did not establish why patients treated by female physicians experienced better outcomes. However, the researchers discussed possible differences in clinical practice and communication.

Female physicians may be more likely to engage in patient-focused communication, spend more time with patients, follow clinical guidelines and involve colleagues in decision-making.

These practices could influence how symptoms are studied, treatment decisions are made and coordinated during hospitalisation.

"The goal is not to favour one group of physicians over another but to identify practices and behaviours that may help improve care across the health system," says Jerath.

"An important strength of this study is that, unlike surgical care, patients admitted to hospital for medical conditions are generally assigned physicians based on rotating schedules rather than patient or referring physician preferences, helping to minimize referral bias."

Eli Lilly's experimental weight-loss drug retatrutide, being referred to as ‘Godzilla’, continues to outperform its rivals like Ozempic.

According to a recent head-to-head Phase 3 clinical trial involving adults with type 2 diabetes, it delivered more than twice the average weight loss achieved with Ozempic.

Ozempic Vs Retatrutide

Participants who took the highest dose of retatrutide lost an average of 20.9% of their body weight over 80 weeks, compared to 9.4% among those receiving Ozempic's highest approved dose for type 2 diabetes.

The trial, called TRANSCEND-T2D-2, involved more than 1,000 adults with type 2 diabetes. It compared once-weekly injections of retatrutide at doses of 9 mg and 12 mg with semaglutide, the active ingredient in Ozempic, at 2 mg.

At the end of 80 weeks, participants taking retatrutide 9 mg lost an average of 44.3 pounds (20.1 kg), while those receiving the 12 mg dose lost 47.4 pounds (21.5 kg). The Ozempic group lost an average of 20.9 pounds (9.5 kg).

The findings mark the first Phase 3 head-to-head comparison of retatrutide with another medicine in this class.

Also read: ‘Godzilla’ Drug Retatrutide Reverses Sleep Apnea In 1 In 4 Diabetes Patients

Retatrutide Also Improved Blood Sugar

The trial found that retatrutide also resulted in produced greater reductions in HbA1c, a measure of average blood glucose over approximately three months.

At 80 weeks, participants taking either dose of retatrutide recorded an average HbA1c reduction of 2.2%, compared to 1.8 % among those receiving Ozempic.

The experimental drug also resulted in greater improvements in cardiovascular risk factors like non-HDL cholesterol, triglycerides and systolic blood pressure.

Also read: Could GLP-1 Drugs Help Prevent Rupture Of Abdominal Aortic Aneurysm? Study Finds 46% Reduction In Risk

Side Effects Of Retatrutide

The most commonly reported side effects of retatrutide were gastrointestinal symptoms like diarrhoea, nausea, constipation, vomiting and indigestion.

Diarrhoea was reported in 28.3% of participants receiving the 9 mg dose and 32.7% receiving 12 mg, compared to 26.4% in the Ozempic group. Nausea occurred in 21.2%, 23.8% and 21.3% of participants, respectively.

Researchers also reported a higher incidence of dysesthesia, an abnormal sensation that can include tingling, burning or skin sensitivity, among participants taking retatrutide.

Treatment discontinuation because of side effects occurred in 4.8% of the 9 mg group and 7.9% of the 12 mg group, compared to 2.7% of the Ozempic group.

More About Retatrutide

Retatrutide is a once-weekly injectable drug that targets three hormone receptors involved in regulating appetite, blood sugar and metabolism. They are GLP-1, GIP and glucagon.

GLP-1 helps regulate appetite and blood sugar while slowing the process of stomach emptying. GIP also plays a role in glucose regulation and insulin release. Glucagon is involved in controlling blood glucose and energy metabolism.

Ozempic, manufactured by Novo Nordisk, acts on the GLP-1 receptor. Eli Lilly's Mounjaro and Zepbound, which contain tirzepatide, target both GLP-1 and GIP receptors.

Retatrutide remains an investigational drug and has not been approved by the US Food and Drug Administration (FDA) or other regulatory authorities.

Eli Lilly plans to submit the drug for FDA approval in early 2027. The company said detailed results from the trial would be presented at a future medical meeting and published in a peer-reviewed journal.