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.

A shingles vaccination effort launched in Wales in 2013 has produced two findings that bring new optimism to dementia research. The program appears not only to lower the likelihood of mild cognitive impairment but also to slow the course of dementia in people who already have the condition. Shingles stems from the varicella zoster virus and causes a painful rash.

Around one in three people in the United States will experience shingles during their lifetime, with the risk rising sharply with age. For this reason, adults aged fifty and older in the United States are advised to receive two doses of the shingles vaccine.

The vaccine has long been known to prevent shingles with an effectiveness above ninety percent for older adults, but recent work suggests it may hold additional advantages.

What Is Shingles?

Shingles, or herpes zoster, is caused by the varicella zoster virus, which is also responsible for chickenpox. It usually presents as a cluster of blistered skin on one side of the body, often forming a band across the torso. After a person recovers from chickenpox, the virus stays in the nerve cells and can reactivate years later, especially when the immune system weakens, according to Mayo Clinic.

What Is Dementia?

Dementia refers to a collection of symptoms that include significant problems with memory, reasoning, and daily function. It results from damage to brain cells caused by several conditions, including Alzheimer’s disease and vascular dementia. Although dementia becomes more common with age, it is not considered a normal part of growing older, as outlined by the World Health Organization.

Shingles Vaccine Linked To Dementia Progression

Growing evidence indicates that receiving the shingles vaccine may lower the chances of developing dementia. A new study, published Tuesday in the journal Cell, builds on earlier research by proposing that the vaccine might also slow existing dementia, which could reduce the risk of death related to the disease.

“We see a change in the odds of dying from dementia among people who already have the condition,” said Dr. Pascal Geldsetzer, an assistant professor of medicine at Stanford University and senior author of the new study.

“That means the vaccine may not only prevent dementia, but it might also serve as a form of treatment because we notice improvements in people already living with the disease,” he said. “This was both surprising and encouraging.” The new study follows earlier work by Geldsetzer and his team showing that shingles vaccination may help delay or prevent dementia.

In that earlier analysis, researchers reviewed health records from older adults in Wales, where a shingles vaccine program for people in their seventies began on September 1, 2013. Under the rules of the program, individuals who were seventy-nine on that date could receive the vaccine for one year, while those aged eighty or older were not included.

That cutoff allowed researchers to compare outcomes between seventy-nine-year-olds who were offered the vaccine and eighty-year-olds who were not eligible but might have chosen to be vaccinated had they been allowed.

Challenges With The Shingles Vaccine And Reducing Dementia Progression

The next task will be to understand why the shingles vaccine might influence dementia risk or progression. The answer may lie in interactions involving the nervous system or immune response. Certain viruses that affect nerve tissue have been linked in animal studies to the harmful protein accumulation seen in Alzheimer’s disease.

Future research may examine larger and more diverse groups of people, and may also explore how the newer shingles vaccine compares with the older version used in Wales in 2013, which has since been replaced.

“At least directing part of our research efforts toward these pathways might bring important progress in both prevention and treatment,” said biomedical scientist Pascal Geldsetzer from Stanford University.

Of the many medicines that we consume on a day to day basis, we are not aware of how gradually they are actually making our health worse. One medicine that is common in many households, especially in India households, as points Dr Obaidur Rahman, Ortho and Sports Surgeon is pantoprazole, popularly sold under the name PAN40, PAN Top or PAN D. These medicines are used to treat and relieve symptoms of heartburn, which is a common symptom of acid reflux and GERD.

"A patient came to me, he was an 80-year-old male. He has a habit of taking this tablet regularly, and because of that he suffered an osteoporotic fracture. This means he fell while walking and fractured," points out Dr Rahman.

Also Read: Shingles Vaccine Linked To Slower Dementia Progression, Study Finds

He says that many people, old and young, alike, have a habit of taking this pill like a multivitamin. In fact, they have substituted with pro and prebiotics and assume that it helps with digestion. However, he points out, "If you take this regularly, your gastric mucosa stops responding against proper acid production. And there is also an impairment in digestion."

He says that in clinical practice, it has been found that this common household medicine, which is often procured as over-the-counter or OTC medicine, meaning, without prescription, could cause Vitamin B12 deficiency, and magnesium deficiency.

What Does The Science Say About Pantoprazole Use?

As per a 2023 study published in the journal BioMed Research International, pantoprazole cause bone loss, which could be prevented by adding octreotide.

The study analyzed the serum levels of calcium, phosphorus, and ALP before starting the treatment, and at the end of 12 weeks of treatment on pantoprazole, significant decline in calcium levels were noticed, as compared with other groups. The study also found that octreotide significantly prevented the effect of pantoprazole on the serum levels of calcium and ALP.

The study also found that pantoprazole decreased femoral bone density and femoral BMAD. Besides this, another decrease was found in the femoral bone weight and volume as well as the trabecular volume.

Another study from 2021, published in the European Journal of Clinical Pharmacology pointed out that 12 patients had major fractures and showed changes in serum Mg2+ and Ca2+ levels over a period of 1 month as well as the animal study also showed ionic imbalance over 8-week treatment with pantoprazole. Bone density measured for the patient at the end of the 1-month treatment was found to be in the osteopenic category, together with the animal study which showed a decrease in femur bone strength for the animal treated with pantoprazole over a period of 8 weeks.

Are There Any Safer Alternatives To Pantoprazole?

Pantoprazole contain Proton Pump Inhibitor (PPI), and prokinetic, long-term use of PPIs is associated with the risk of bone fracture. However, alternatives like Histamine H2-receptor antagonists or H2 blockers are effective alternative that do not cause bone loss, notes a 2020 study published in journal Bone, titled Comparative analysis of the risk of osteoporotic fractures with proton pump inhibitor use and histamine-2 receptor antagonist therapy in elderly women: A nationwide population-based nested case-control study.

The safer alternatives are:

Famotidine (Pepcid, Calmicid, Fluxid, Mylanta AR) is a potent H2 blocker used to manage acidity and heartburn. Studies show that famotidine is not thought to raise the risk of osteoporosis.

Other options: Ranitidine (Zantac - where available, as it was withdrawn in some markets due to safety concerns) and Nizatidine are other H2 blockers.

Note: Health & Me do not encourage discontinuance of any prescribed medicine by a doctor. Before making any change in your medicine schedule, please speak to your doctor/GP.

This flu season could be brutal, say the early clues that scientists have gathered. This comes as the world already struggles keeping up with the new variants of COVID, however, the COVID rates in the US appears to be low. Though researchers are expecting the virus to circulate more widely in the coming months as people gather for holidays.

This is also the time for common cold. Dr William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center tells the New York Times that if you feel ill, but your symptoms remain only above the neck, that is, a stuffy nose, a sore throat, then it could just be a common cold.

However, if the symptoms lead to hacking cough, and down the neck, which makes your muscles ache and body tired, that it could be a flu or COVID. Due to the similarities in the symptoms, even infectious disease specialists also struggle to tell the difference.

Symptoms To Take A Note Of

COVID

How it begins: Initially, symptoms of COVID can mimic flu-like symptoms

What are the primary symptoms of COVID?

• Loss of taste
• Loss of smell
• Sore throat: the new variants are also causing razor-sharp pain in the throat
• Diarrhea or stomach upset

The biggest difference here is the dry and persistent coughing, which when you have a cold will not be dry in nature.

How it impacts? The COVID may vary from mild to severe

Since the pandemic, Covid has blurred the lines between seasonal infections. Current strains can trigger flu-like fatigue, fever, and cough. But the loss of taste or smell and digestive issues are stronger indicators of Covid.

For confirming COVID, test is the only key. There are now at-home tests available online and at drugstores too. An at-home test could detect both, a flu and COVID.

Common Colds

How it begins: The symptoms of common cold starts gradually.

What are the primary symptoms of Common Cold?

• Stuffy or runny nose
• Sore throat, but not razor-blade like pain
• You may feel pressure in the ears

Here, the biggest difference is also in cough, which is often mucus-filled and chesty. Whereas in COVID, the cough is dry.

How it impacts? While it is annoying in the beginning, especially due to the blocked nose and ears, the congestion clears up overtime and usually doesn’t stop daily activities.

Colds typically start with a tickle in the throat or pressure in the ears before progressing to nasal congestion and cough. Most people can carry on with their routines despite the discomfort.

Flu

How it starts? In many cases, the flu may catch you out of the blues, many describe the onset as sudden.

What are the primary symptoms of Flu?

• Fever
• Chills
• Muscle aches
• Exhaustion

While the cough here is also dry in nature, which may make one get confused with COVID, there is no razor-blade like symptom, which can be used as a marker to differentiate.

How does it impact? Flu often requires bed rest.

Unlike a cold, flu can leave you feeling completely wiped out. Body aches and high fever are distinguishing features, and recovery often takes several days of rest.