World Aids Day
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.
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.
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.
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.
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.
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.
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.
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Someone who is dying may start to their loved ones who passed away years ago. This could be unsettling and confusing for families and relatives who may assume that the person is just hallucinating or undergoing a deeper neurological issue.
But hospice physician Dr Christopher Kerr says such experiences are a known phenomenon called end-of-life dreams and visions (ELDVs). Kerr, chief medical officer of Hospice Buffalo, has spent decades studying these experiences in dying patients extensively.
Appearing on The Oprah Podcast, he told Oprah Winfrey that many patients near death describe seeing deceased relatives or people who cared for them during their lives. The experiences can feel completely real to them.
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One of the possibilities is that the brain experiences significant changes as the body starts to shut down.
Alterations in sleep, consciousness, metabolism, oxygen levels, medications, and brain chemistry can all affect perception during the final stages of life.
Dr. Rakesh Lalla, Additional Director - Neurology, Fortis Hospital, Mumbai, told HealthandMe, " These visions could be explained by the alterations that occur within the brain as the body starts to close down. Due to oxygen deprivation and altered brain activity, the brain would process memories, feelings, and stimuli differently. The areas responsible for memory processing and vision could become stimulated or disrupted, which could result in some vivid visions or experiences."
The expert also said that these visions do not mean that the person has a neurological or psychiatric issue.
Dr. Lalla said, "They do not necessarily mean that the person is confused or suffering from a psychiatric condition. In many cases, they are brief, peaceful, and emotionally meaningful to the individual. We still do not fully understand why particular people or memories appear."
The neurologist also advised families to stay supportive and calm during such situations.
He added, "The brain’s complex relationship between memory, emotion and perception is likely to play an important role. For families, the key is to remain calm, listen without dismissing the experience, and provide reassurance and comfort."
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Experts who have been studying ELDVs have also found that these experiences have some distinctive patterns that do not resemble random hallucinations.
In a 2014 longitudinal study led by Kerr, most of the 59 hospice patients who completed the study reported at least one dream or vision. Almost half occurred during sleep, and nearly all patients said the experiences felt real. The most common involved deceased friends or relatives or other loved ones. In fact, comforting visions of deceased people became more common as patients moved closer to death.
A 2026 systematic review of 13 studies similarly found that ELDVs occurred in at least one in five dying adults.
The National Institute on Aging also states that dying people may appear to see or talk to someone who is not present and may report dreams involving deceased relatives or friends. Such experiences are often comforting, and caregivers are generally advised not to immediately correct or challenge the person.
Kerr said that patients seeing deceased loved ones in their visions appeared calmer afterward. His research suggests that these experiences may carry deep emotional meaning for patients.
“Very little is said between the person in the dream and the dreamer, but everything seems to be understood,” Kerr told Oprah.
Scientists still cannot say exactly what produces these experiences or whether they represent anything beyond changes occurring in the dying brain.
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India accounts for one-fifth of global deaths due to cardiovascular diseases (CVDs) or complications related to the heart and blood vessels. Moreover, women are more vulnerable to these complications. Recent data show that women (14%) have a higher prevalence of CVD than men (12%), making preventive care very important for all.
The human heart works constantly and efficiently and can compensate for metabolic stress and narrowing of blood vessels without showing any obvious symptoms. Hence, a heart health evaluation should ideally take place when the person is feeling completely well, long before any warning signs appear.
While acute symptoms, such as chest pressure or tightness, unexplained breathlessness, fainting, or unusual fatigue on effort, demand immediate attention, true heart protection occurs through early and planned tests. While heart check-ups are routinely recommended starting at age 40, screening should ideally begin earlier, around ages 30 to 35, especially if risk factors are present.
Starting check-ups at age 30 is important because certain congenital and structural heart conditions remain completely silent for years, and early screening ensures timely, targeted treatment when it is most effective.
Regular screening helps detect and rule out underlying issues early, including congenital heart defects (commonly known as holes in the heart) and conditions such as Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), or Patent Ductus Arteriosus (PDA). Structural and muscle diseases, on the other hand, include valve disorders, heart muscle weakness, or abnormal thickening of the heart walls (e.g., Hypertrophic Obstructive Cardiomyopathy (HOCM)).
In addition to age, patients should seek a heart check-up sooner if they have any of the following risk factors:
Excess body weight, especially central or abdominal obesity. Excess body weight damages the kidneys, leads to fat deposits in the liver and increases the risk of developing diabetes, and ultimately increases the strain on the heart and blood vessels (cardiovascular system). These interconnected conditions are known as Cardiovascular-Kidney-Metabolic (CKM) syndrome and include heart disease, kidney disease, diabetes, stetotic (fatty) liver disease, and obesity.
Effective weight and metabolic management, through modern options such as oral or injectable GLP1 therapies, can improve long-term heart health.
A heart check-up can involve several tests, from blood tests to invasive or non-invasive ones (with/without needles, catheters, or probes entering the body). The most common blood tests include fasting and post-prandial or after-meal blood sugar (FBG/PPBG), HbA1c (glycated haemoglobin), lipid and thyroid profile, and kidney function tests. Non-invasive cardiac tests include electrocardiogram (ECG), 2D echocardiogram, and ultrasound. However, not everyone needs all of them.
Diagnostic tests should be customized based on the person’s age, symptoms, and individual risk score. Hence, skip the urge to self-order commercial diagnostic packages online. Instead, take the most important step towards protecting your heart by talking to your doctor. A personalized assessment can help determine which tests, if any, are appropriate for you, so that you can focus on the right steps to keep your heart healthy.
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Gut chemicals may play a role in influencing the likelihood of someone developing Alzheimer's disease. A new study has a chemical produced by certain gut bacteria in focus that may affect Alzheimer’s disease risk, cognitive decline, and other changes related to the disease.
Published in Nature Communications, the study focused on imidazole propionate (ImP), a metabolite produced by some gut bacteria when they break down the amino acid histidine.
Researchers found that people with higher levels of ImP in their blood had lower cognitive scores and higher levels of biomarkers that indicate the likelihood of Alzheimer’s disease and neurodegeneration.
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The researchers studied health data from 1,196 adults who were cognitively unimpaired, with an average age of about 61 years. Higher blood levels of ImP were associated with poorer cognitive performance and faster age-related decline.
Higher ImP was also linked to increased levels of p-tau217, a key biomarker in Alzheimer’s pathology, and neurofilament light chain, a marker of nerve-cell damage.
The finding builds on earlier work from the University of Wisconsin-Madison team showing differences in gut microbes between people with Alzheimer’s and those without the disease.
“Since then, we've been trying to figure out how this difference in the gut perhaps leads to changes in the brain,” said Barbara Bendlin, professor of medicine at the University of Wisconsin-Madison.
But ImP itself may be more relevant than simply having a particular type of gut bacteria.
“ImP-producing bacteria are present in a large fraction of people, but they're not very abundant in most people,” said Federico Rey, professor of bacteriology at the University of Wisconsin-Madison. “But something we have learned over the years is that a microbe doesn't have to be abundant to have an impact on the host.”
The researchers also found genetic evidence that linked higher ImP levels with an increased risk of Alzheimer’s. In experiments on mice, long-term exposure to ImP increased amyloid-beta plaques and signs of brain inflammation.
Laboratory experiments further suggested that ImP could affect the blood-brain barrier and promote tau hyperphosphorylation, a process involved in nerve damage that occurs in Alzheimer’s.
Researchers also caution against making changes to diet to alter gut bacteria. They say ImP is produced when bacteria metabolise histidine, an amino acid that the body needs and that is found in many protein-rich foods.
“Generally improving your diet would probably help,” Bendlin said. “But it's not as easy as saying, 'Stop eating eggs' or 'Don't eat so much red meat.' Because you need histidine, and it's all over the place.”
Instead, the researchers are looking at whether ImP itself could eventually be targeted.
“It could be just like cholesterol, where people with elevated cholesterol take a drug, a statin, that reduces their risk for heart disease,” Bendlin said. “If we can find an inhibitor that can help decrease the levels of ImP in the blood, that could hopefully reduce the risk of Alzheimer's and the speed of cognitive decline for a significant number of people.”
Researchers also say that the findings do not show that ImP causes Alzheimer’s in humans, nor do they suggest that probiotics or dietary changes can prevent dementia.
But they strengthen growing evidence that suggest chemicals produced by gut microbes may affect brain health years before symptoms surface.
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