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.
Credit: AI
Massive wildfires have ravaged several parts of Canada and other regions of the world, filling the air with hazardous smoke. This has triggered health warnings far beyond the fire zones.
While most people experience immediate breathing problems during and after wildfires, experts say that some health effects can persist long after the skies clear.
Wildfire smoke is composed of harmful gases and microscopic particles known as PM2.5. These tiny particles are small enough to travel into our lungs and enter the bloodstream, where they can trigger inflammation throughout the body.
Unlike typical air pollution, wildfire smoke also contains toxic substances released from burning homes, plastics, furniture, vehicles, electronics, and industrial materials, making prolonged exposure particularly harmful.
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Prolonged exposure to wildfire smoke can have long-term effects on the respiratory system. Possible health effects may include:
Children, older adults, and people with existing lung conditions face the highest risk because their lung function is already compromised.
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The tiny particles in wildfire smoke don't just stay confined to the lungs. Once they enter the bloodstream, they can affect the cardiovascular system. In the long run, research says wildfire smoke exposure can lead to:
With frequent incidences of wildfires, scientists are looking into how wildfire smoke affects the brain. Emerging evidence suggests smoke exposure may contribute to:
Wildfires can affect mental health in more than one way. Besides the stress of evacuation and property loss, smoke exposure itself may contribute to mental health problems directly. One is at the risk of the following mental health issues after exposure:
Communities repeatedly exposed to wildfire events may experience prolonged psychological distress that could often go undetected.
Growing evidence suggests that long-term exposure to wildfire smoke may increase the risk of several cancers. Studies have reported possible associations with lung cancer, breast cancer, colorectal cancer, bladder cancer, and certain blood cancers
Although researchers say more studies are needed to establish a direct cause-and-effect relationship, the findings highlight the importance of limiting repeated smoke exposure.
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Pregnant women are among the groups considered most vulnerable to wildfire smoke. Research suggests exposure during pregnancy may increase the risk of preterm birth, low birth weight and other pregnancy complications.
Healthcare providers recommend minimizing outdoor exposure whenever air quality deteriorates.
Even after visible smoke disappears, harmful particles may remain in the air. Experts recommend:
Credit: AI
When we think of dialysis, we often picture a machine filtering blood and keeping patients alive. What rarely comes to mind is the small blood vessel in the arm that makes the entire process possible.
For every patient on haemodialysis, the arteriovenous (AV) fistula is quite literally a lifeline. Without it, dialysis cannot be performed effectively. Yet, despite being one of the most important parts of treatment, fistula care remains one of the least understood aspects of kidney disease.
This silent gap in awareness is costing patients their lifeline.
India adds nearly 2.2 lakh new patients with end-stage kidney disease every year, creating a demand for over 3.4 crore dialysis sessions annually.
One of the biggest challenges we see in clinical practice is that patients often seek medical help only after the fistula has already stopped functioning.
The warning signs are usually ignored.
The vibration over the fistula becomes weaker. The arm begins to swell. Bleeding continues longer than usual after dialysis. Needle insertion becomes increasingly difficult. Sometimes dialysis itself becomes less effective.
By the time patients reach an interventional radiologist or vascular specialist, the fistula may already have developed significant narrowing (stenosis) or complete blockage.
Unfortunately, many of these complications are preventable if detected early.
In our experience, nearly 30% of patients eventually lose their fistula because they report too late, when timely intervention could have salvaged access.
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Unlike diabetes or blood pressure, there is no widespread public awareness around fistula surveillance.
Many dialysis patients receive instructions on medicines and dialysis schedules but very little education on how to examine their fistula every day.
There is also no universally implemented patient education protocol across dialysis centres, leading to inconsistent awareness about fistula care.
The result is simple: patients unknowingly damage the very access that keeps them alive.
Patients should examine their fistula daily.
A healthy fistula has a continuous buzzing sensation or “thrill.” If this vibration becomes weak or disappears, medical attention should be sought immediately.
Similarly, swelling of the arm, redness, prolonged bleeding after dialysis, pain around the fistula, or difficulty during needle insertion should never be dismissed as routine.
These are early warning signs - not inconveniences.
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These small daily habits can often extend the life of a fistula by years.
One of the greatest advances in dialysis access care is that many fistula problems no longer require open surgery.
If narrowing is detected early, minimally invasive image-guided procedures such as fistuloplasty (balloon angioplasty) can restore blood flow, preserve the existing fistula and help patients continue dialysis without interruption.
The key, however, is timing.
A fistula that is evaluated early is often salvageable.
A fistula ignored for weeks may not be.
Every successful fistula represents months of planning, surgery and healing. Losing it means additional procedures, temporary catheters, higher infection risk, increased costs and emotional distress for patients already living with chronic kidney disease.
As doctors, we have become increasingly skilled at creating dialysis access.
The next challenge is ensuring patients know how to protect it.
Because for someone living with kidney failure, the fistula is not just another blood vessel.
It is the lifeline that keeps life moving.
By Dr. Avik Bhattacharyya, Senior Consultant - Interventional Radiology, CK Birla Hospitals, CMRI
Credit: iStock
GLP-1 drugs such as Ozempic, Wegovy, Mounjaro and liraglutide, best known for regulating appetite and aiding weight loss, may also help reduce symptoms of binge eating disorder (BED), which affects more than 17 million people worldwide, according to a new study.
The systematic review and meta-analysis, published in the journal eClinicalMedicine, found that GLP-1 drugs, with semaglutide as its key ingredient, reduced binge eating episodes, loss-of-control eating and emotional eating, highlighting their potential role in treating binge eating disorder alongside obesity.
Binge eating disorder affects over 17 million people globally, and around two-thirds of people with the condition also live with overweight or obesity. It is also common among individuals seeking weight-loss treatment.
"Binge eating disorder, where people regularly eat an excessive amount of food while feeling they have lost control, is common and highly impairing, affecting over 17 million people worldwide," said lead author Dr Ilaria Costantini from the Psychiatry Department at University College London (UCL), UK.
"But treatment options are limited and there are currently no approved medications, so there remains a need for better ways to help people living with this condition. We found evidence that weight loss drugs may help to manage some key symptoms of binge eating disorder," Costantini added.
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The researchers analyzed 25 randomized controlled trials conducted across 12 countries on four continents, involving 8,069 participants.
The trials evaluated GLP-1 drugs that target the appetite-regulating hormone GLP-1, including semaglutide (marketed as Ozempic or Wegovy), tirzepatide (Mounjaro) and liraglutide.
These medications suppress appetite by acting on the central nervous system and insulin secretion, delay stomach emptying, and may also influence brain pathways involved in reward and impulse control.
Compared with placebo or other treatments, people taking GLP-1 drugs reported:
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The researchers also found that participants taking GLP-1 drugs reported greater cognitive or dietary restraint, meaning they made more deliberate efforts to limit what they ate.
The benefits extended beyond weight loss, with improvements seen in several behaviors associated with binge eating disorder.
While increased dietary restraint was observed, the researchers cautioned that it remains unclear whether this represents healthy self-regulation or a more rigid, potentially harmful eating pattern that could worsen binge eating over time.
"From the evidence available, we cannot say whether the increase in dietary restraint reflects a positive and helpful form of self-regulation or if it is a more dysfunctional pattern of eating. We hope that future research can clarify whether or not taking weight loss drugs might contribute to more pathological forms of eating restriction such as meal skipping," said Izzy Emptage from UCL Psychiatry.
The researchers said GLP-1 drugs could become an important addition to treatment plans for binge eating disorder when used alongside psychological therapies and social support.
However, they also highlighted important limitations. Most of the studies included in the review had a high risk of bias, were funded by pharmaceutical companies, and rarely included participants with a clinical diagnosis of binge eating disorder, reducing the certainty of the findings.
"GLP-1s may offer a promising additional treatment option for people living with both binge eating and obesity," the researchers said, while stressing that these drugs "should not be viewed as a standalone solution to binge eating disorder."
They added that larger, independently funded clinical trials are needed before these medications can be routinely recommended for treating binge eating disorders.
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