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
Ravi is 34 years old. He goes to the gym three times a week, weighs a healthy 68 kg, and has never been diagnosed with diabetes or high blood pressure. During his company's annual health check-up, an ultrasound revealed four unexpected words: Grade 1 Fatty Liver.
Like many people, Ravi was shocked. "How is that possible?" he asked. "I'm not overweight."
The answer reflects a growing reality that is changing how liver specialists understand one of India's fastest-growing liver diseases.
For years, fatty liver—now medically known as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)—was considered a condition affecting people who were overweight, had diabetes, or consumed excessive alcohol.
That understanding is no longer complete.
Today, we increasingly diagnose fatty liver in individuals who are lean, appear metabolically healthy, and do not consume alcohol. This condition, often referred to as lean MASLD, accounts for nearly 10–20% of fatty liver cases in Asia. Given the unique genetic and metabolic profile of South Asians, the true burden in India may be even higher.
So, What Is Actually Going On? The reasons are more complex than body weight alone—and many are hiding in plain sight.
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Certain genetic variants, particularly PNPLA3, make the liver more likely to store fat even when the rest of the body appears healthy. This genetic predisposition is significantly more common among South Asians than Western populations.
In other words, you may be lean, eat reasonably well, and still develop fatty liver because of your inherited biology.
A normal body weight does not always mean a healthy metabolism.
Many lean Indians carry excess visceral fat—fat stored around internal organs rather than under the skin. This "skinny fat" phenomenon is especially common in our population and is strongly linked to liver fat accumulation and inflammation, despite a normal BMI.
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A diet rich in refined carbohydrates and added sugars can overwhelm the liver.
Frequent consumption of foods such as white rice, refined flour (maida), packaged snacks, biscuits, sugary beverages, and fruit juices provides excess fructose, which the liver converts directly into fat.
Over time, this process promotes fatty liver—even in individuals who never become overweight.
By Dr. Chetan Kalal, DM Hepatology, Liver Transplant Specialist, Saifee Hospital, Mumbai
Credit: AI
For most people, dengue is associated with high fever, severe body aches, headache, fatigue, and a temporary drop in platelet count. With proper care, the majority of patients recover completely within a couple of weeks. However, doctors caution that in rare instances, dengue can leave behind an unexpected complication that affects the nervous system rather than the blood—Guillain-Barre syndrome (GBS).
GBS is an uncommon autoimmune disorder in which the body's immune system mistakenly attacks the peripheral nerves. It usually develops after an infection, and growing evidence suggests that dengue can be one of the infections capable of triggering this immune response. While the chances remain low, the condition can progress rapidly and requires prompt medical attention.
The condition affects the nerves and can cause increasing weakness in the legs, arms, face and swallowing.
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Unlike the fever and body pain seen during active dengue infection, GBS often appears days or even weeks after the patient seems to be recovering. This delay can make it easy to overlook the connection.
Our immune system protects our body by fighting infections. In some rare cases an infection like dengue can trigger a strange immune response where our body mistakenly attacks its own nerves.
Nerves carry signals between our brain and the rest of our body allowing us to move and feel normally. When nerves get damaged it disrupts the signals from our brain leading to muscle weakness tingling and other symptoms.
Someone who has recently recovered from dengue may suddenly notice tingling in the feet or hands, weakness in the legs, difficulty climbing stairs, or an unsteady walk. As the condition progresses, the weakness may spread upwards, affecting the arms, facial muscles, swallowing, or even the muscles responsible for breathing.
The exact reason this happens is believed to be an abnormal immune response. Instead of switching off after fighting the dengue virus, the immune system mistakenly attacks the protective covering of the nerves, disrupting the signals between the brain and muscles. This results in the characteristic muscle weakness seen in GBS.
Guillain-Barre syndrome usually develops when we are recovering from dengue or even days to weeks after the fever has gone away.
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Feeling tired and fatigued is common, after dengue. Usually gets better slowly. However, we need to differentiate it from weakness. Neurological weakness means our muscle movements are affected.
It often starts in our legs. We may notice it is getting harder to climb stairs get up from a chair or walk normally. This weakness can sometimes spread to our arms and face. In cases it can even affect our swallowing or breathing which may require ICU and ventilator support.
Although dengue-related GBS is rare, recognising the warning signs early can make a significant difference. Timely diagnosis and treatment can help reduce complications and improve recovery.
Any person who develops new weakness, numbness, difficulty walking, facial drooping, trouble swallowing, or breathlessness in the weeks following dengue should seek immediate medical evaluation rather than assuming it is part of normal post-viral fatigue.
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The reassuring news is that most people with dengue will never develop Guillain-Barre syndrome. Nevertheless, awareness remains important because the condition can become serious if left untreated.
Preventing mosquito bites, eliminating stagnant water around homes, and seeking medical care early for suspected dengue remain the best ways to reduce the risk of both the infection and its uncommon complications.
The main thing to remember this monsoon is simple: feeling tired after dengue's normal but if our weakness is getting worse we should not ignore it. Recognizing this difference. Getting medical help early can help us identify this rare but treatable complication on time.
As dengue cases rise during the monsoon, recovery should not simply be measured by the disappearance of fever. Paying attention to new neurological symptoms after the illness has resolved can help ensure that a rare but potentially life-threatening complication is recognised before it becomes an emergency.
By Dr. Abizer Manked, Consultant Physician and Diabetologist at Saifee Hospital, Mumbai and Dr. Arun Shah, Director Neurosciences, Sir HN Reliance Foundation Hospital, Mumbai
Credit: AI
A small lump in the neck is easy to overlook. In many cases, such swellings are linked to minor infections and settle on their own. But not every neck lump is harmless. The neck houses numerous vital structures, including lymph nodes, glands, blood vessels, and nerves, all within a compact area.
As a result, a seemingly minor swelling can sometimes be an early sign of an underlying condition that requires timely medical attention.
The neck houses important organs and tissues, including the thyroid gland, lymph nodes, salivary glands, major blood vessels, and nerves.
This area can be deceptive for two reasons:
Adding to the challenge, many serious neck conditions, including certain cancers may not cause pain in their early stages.
It’s been observed that the majority of neck swellings are benign.
Common non-cancerous causes include:
Reactive lymph nodes: Often develop after a cold, sore throat, dental problem, or skin infection. They are usually tender and tend to resolve within a few weeks.
Thyroid nodules: Quite common in adults and often harmless. These lumps typically move when swallowing.
Cysts: Such as branchial cleft cysts or sebaceous cysts, which are generally smooth, rounded, and slow-growing.
Lipomas: Soft fatty growths that can move easily beneath the skin.
Tubercular lymph node enlargement: Still frequently seen in India, presenting as gradually enlarging, usually painless neck nodes.
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While many neck lumps are harmless, certain features warrant a consultation with a doctor within one to two weeks:
Associated symptoms such as unexplained weight loss, mouth ulcer, persistent fever, night sweats, hoarseness, difficulty swallowing, chronic cough, or unexplained ear pain
Individuals with a history of tobacco use, alcohol consumption, previous radiation exposure, HPV-related disease, or a family history of thyroid cancer or lymphoma should be especially vigilant.
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Early diagnosis is key to ensuring the most effective treatment.
Evaluation typically begins with a detailed clinical examination, as the location of the lump often provides important clues.
Common investigations include:
When cancer is detected early, treatment is often less extensive and outcomes are significantly better.
Several common mistakes contribute to delayed diagnosis:
Seeking expert assessment early can prevent complications and improve treatment options.
A quick self-examination can help identify changes early.
A neck lump is often nothing more than a temporary response to infection or inflammation. However, some conditions, including cancers of the thyroid, lymph nodes, and head and neck region can present as painless swellings long before other symptoms appear.
The key is not to panic, but not to ignore it either. When it comes to neck swellings, early evaluation can make the difference between a straightforward treatment and a much more complex journey later on.
By Dr Akshay Kudpaje, HOD/Senior Consultant - Head & Neck Oncology at HCG Cancer Hospital, Hebbal, North Bangalore
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