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.

Recurring abdominal pain is often dismissed as acidity or indigestion. This becomes a matter of concern when persistent pain reaches the back and causes vomiting and weight loss. These are symptoms of a more serious disease such as chronic pancreatitis.

A recent case highlights the importance of recognizing the condition early. A 35-year-old mother of two had been living with severe upper abdominal pain for nearly three years. She experienced episodes that required hospital admission. Upon detailed investigations, it was confirmed to be a case of chronic idiopathic calcific pancreatitis. Long-standing inflammation had caused stones to develop within the pancreatic duct, which blocked the normal flow of digestive juices and triggered repeated attacks of pain. The underlying problem remained unresolved. To the patient, the mental toll of being a daily-wage worker came with loss of income and disruption to family life.

Chronic pancreatitis is when repeated inflammation causes permanent damage to the pancreas. Gradually, the gland becomes scarred, the pancreatic duct narrows, and stones develop. Pressure within the pancreas increases, thereby causing recurrent abdominal pain. As the disease advances, patients may also develop difficulty digesting food, unintended weight loss, nutritional deficiencies, and diabetes due to loss of pancreatic function. There exist multiple causes of chronic pancreatitis such as alcohol, gallstones, smoking, genetic disorders, autoimmune diseases and certain metabolic conditions. In a proportion of patients, no definite cause can be identified despite extensive evaluation.

Diagnosis is made on clinical grounds and imaging modalities such as ultrasound, CT scan, or MRI, which are helpful in identifying changes in the pancreas and detecting ductal stones. Early diagnosis is essential to prevent further complications and long-term outcomes. Treatment is modified according to the severity of the illness and the patient's signs and symptoms. Initial management is done in the form of dietary modifications, enzyme supplementation, and avoidance of substances such as alcohol and tobacco. However, when pain persists despite medical treatment, surgery may be required to relieve the obstruction and restore pancreatic drainage. This also occurs when stones obstruct the pancreatic duct,

In this patient's case, the severity of the case warranted surgery in order to ensure the best chance of lasting relief. Prior to the surgery, the patient consulted multiple hospitals before treatment. She underwent a minimally invasive robotic-assisted procedure to remove the pancreatic duct stones and create a new drainage pathway for pancreatic secretions. She had been advised open surgery but delayed it because she feared the large incision and long recovery; before this, she was admitted every 2-3 months for severe pain. The surgery was performed through small incisions with reduced tissue trauma as compared to conventional open surgery. The recovery was unsuccessful, and the patient was discharged with pancreatic enzyme supplementation.

Three months later, she was free from the disabling pain that had dominated her life. She had returned to work and was able to resume her daily routine.

Available treatment options have increased due to minimally invasive and robotic techniques for selected patients, but they may not be suitable for everyone. The choice of treatment is dependent on multiple factors such as the stage of the disease, the anatomy of the pancreas, and the patient's overall condition.

The more important message, however, extends beyond surgery. Persistent pain should never be ignored or considered a common passing occurrence; neither should it be repeatedly treated with painkillers without identifying the cause.

Earlier diagnosis and timely referral can be encouraged by raising awareness amongst the general public to prevent recurring hospital visits. Awareness can make the difference between years of repeated hospitalizations and a return to a healthier, more productive life.

(Dr. Sreedhara V., Surgical Gastroenterologist, Apollo Hospitals Bannerghatta Road, Bengaluru)

Liver cancer rarely announces itself. It creeps in without warning, and by the time symptoms surface, the disease has often progressed to a stage where treatment options shrink, and outcomes worsen. That's why doctors have long called it a "silent killer."

In India, the threat is growing. Rising rates of hepatitis infection, fatty liver disease, and lifestyle-driven risk factors are pushing the numbers up.

Data from the World Health Organization's International Agency for Research on Cancer (IARC) shows more than 40,000 new liver cancer cases reported in India, a figure that underscores a mounting public health challenge. The disease also carries a high mortality rate, largely because most cases surface only once treatment options have narrowed.

This fits into a much larger global picture: WHO's newly released Global Status Report on Cancer 2026 warns that annual cancer cases worldwide could climb from 20.6 million today to nearly 35 million by 2050 without urgent intervention, with infections like hepatitis B and C among the preventable risk factors driving a significant share of the burden.

Why Does Liver Cancer Stay Hidden?

The liver is a workhorse organ, filtering toxins, storing nutrients, and keeping the body running, and it can keep functioning almost normally even after cancer takes hold. That resilience is precisely what makes early detection so difficult. When symptoms do appear, they're vague enough to be mistaken for something else entirely:

• Unexplained weight loss
• Persistent fatigue and weakness
• Upper abdominal pain
• Loss of appetite
• Yellowing of the skin and eyes
• Abdominal swelling

Because these signs surface late, patients often delay seeking care, which is exactly why regular health checkups matter most for high-risk groups, including people with chronic liver disease, hepatitis infection, or fatty liver.

What's Driving the Risk?

Liver cancer doesn't appear overnight; it's the result of years of accumulated damage. Key contributors include:

• Chronic Hepatitis B and C infections, among the leading causes worldwide
• Liver cirrhosis, where scar tissue replaces healthy liver tissue
• Fatty liver disease, increasingly common in India amid rising obesity and diabetes
• Excessive alcohol consumption, which steadily damages liver cells
• Family history of liver disease or cancer
• Exposure to toxins through contaminated food
• Smoking, which raises overall cancer risk

India's shifting disease landscape, sedentary routines, poor dietary habits, and metabolic disorders like obesity and diabetes, means liver cancer is no longer just an infectious-disease concern. It's increasingly a lifestyle disease too.

Can It Be Prevented?

The good news: much of this risk is manageable.

• Get vaccinated against Hepatitis B to block the long-term viral infection that often leads to cirrhosis
• Maintain a healthy weight through diet and regular activity, as obesity is closely tied to fatty liver disease
• Manage diabetes and metabolic health, since insulin resistance accelerates liver damage
• Limit or avoid alcohol, a leading cause of cirrhosis
• Avoid tobacco, which compounds cancer risk
• Stay on top of routine screening if you're at risk; this is one of the most critical preventive steps and includes:
  • Liver function tests (LFTs) to catch early signs of inflammation or damage
  • Ultrasound scans every 6 months for those with cirrhosis, chronic hepatitis B or C, or advanced fatty liver disease
  • Alpha-fetoprotein (AFP) blood tests, used alongside imaging to flag early tumour changes
  • Advanced imaging (CT or MRI) for more detailed evaluation in high-risk cases

Paired with lifestyle changes and timely medical care, these steps can meaningfully lower the risk of developing liver cancer and support long-term liver health.

Know When to Seek Medical Help

Because liver cancer tends to progress silently, early detection is everything when it comes to improving outcomes. Doctors typically rely on a combination of diagnostic tools, ultrasound scans, AFP blood tests, CT or MRI imaging, and in some cases a liver biopsy, to catch the disease at a more treatable stage.

When caught early, treatment can significantly improve survival odds. The right approach depends on the stage of disease, liver function, and the patient's overall health:

• Liver resection, surgically removing only the cancerous portion of the liver, when the disease is localized
• Liver transplant, replacing the entire diseased liver with a healthy donor liver, in select cases
• Ablation, using radiofrequency or microwave energy to destroy cancer cells with heat
• Targeted therapy, drugs designed to attack specific cancer cells while sparing healthy ones
• Immunotherapy, strengthening the body's own immune system to identify and fight cancer cells

Liver cancer is serious and life-threatening, but early diagnosis through screening, paired with timely medical intervention, can meaningfully improve treatment success and survival rates.

(By Dr. Kundan, Consultant - Surgical Oncology, Manipal Hospital, Ghaziabad_

Women have a higher overall risk and prevalence of Alzheimer’s disease and certain other forms of dementia, partly because they tend to live longer than men and because of changes in estrogen levels after menopause.

A new study by researchers from the University of East Anglia (UEA) and the University of Exeter suggests that hormone replacement therapy (HRT) may be associated with a lower risk of dementia in some women.

“Dementia affects millions of people worldwide, with women making up almost two-thirds of Alzheimer’s disease cases, the main form of dementia. As populations age, understanding how sex-specific factors influence dementia risk is increasingly important,” said Prof Anne-Marie Minihane from UEA’s Norwich Medical School, who led the study.

HRT Linked To Lower Alzheimer’s Risk

The study, published in the journal Alzheimer’s & Dementia, analyzed health data from more than 180,000 postmenopausal women in the UK.

The findings showed:

• 16% lower risk of Alzheimer’s disease among women who had used HRT compared with those who had never used it.
• 10% lower risk of dementia overall was associated with HRT use.
• 26% lower risk of any dementia among women who had undergone surgical menopause and used HRT.
• 16% lower risk of any dementia among women with lower lifetime estrogen exposure due to later menstruation or earlier menopause.

Which Groups Benefited More From HRT?

The association between HRT use and lower dementia risk was stronger in certain groups. These include:

• Women who underwent surgical menopause: Those who used HRT had a 26% lower risk of dementia compared with non-users.
• Women with lower lifetime estrogen exposure: Those who started menstruating later or experienced menopause earlier had a 16% lower risk of dementia with HRT use.
• APOE4 carriers: The association between HRT use and lower dementia risk was stronger among women carrying the APOE4 gene variant, a known risk factor for Alzheimer’s disease.
• Women who started HRT between ages 46 and 56: This group experienced the greatest reduction in dementia risk.
• Timing may matter: The findings support the “critical window” hypothesis, suggesting HRT may offer greater benefits when started closer to the menopausal transition rather than later in life.

Could HRT Support Personalized Care?

The researchers said the findings add to growing evidence that the effects of hormone therapy on brain health are complex and may vary between women.

“While HRT has long been prescribed primarily to relieve menopausal symptoms such as hot flushes and night sweats, this work suggests it may also play a role in long-term cognitive health for some women,” Prof Minihane said.

The latest findings build on previous research from UEA, which found that HRT use was associated with better memory, cognition and larger brain volumes later in life among women carrying the APOE4 variant.

The team said the findings could help support more personalized approaches to HRT prescribing, taking into account factors such as menopause type, genetic risk, lifetime hormone exposure and age at HRT initiation.

Prof David Llewellyn of the University of Exeter Medical School said the findings help identify which women may be more likely to benefit from HRT and when treatment may have the greatest effect.