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
Many people may dismiss swelling in an arm or leg, particularly if it's not painful. But if the swelling continues or keeps coming back, it could be a sign of lymphedema, a condition that affects the body's lymphatic system.
The lymphatic system is responsible for draining excess fluid from body tissues. If this system is damaged or is not functioning correctly, fluid will accumulate, and lead to swelling. There are different causes of lymphedema such as some infections, injuries, congenital disorders and cancer therapies. Women who have had breast or gynaecological cancers may be at special risk if they had their lymph nodes removed or if radiation had been used.
Sometimes, lymphedema develops gradually. Signs and symptoms include swelling of one arm or leg, heaviness or tightness in the arm or leg, trouble putting on rings or a watch, and decreased movement in the arm or leg.
At times, the skin can also be tight and turn into a hard consistency over time. In certain patients, a second infection of the skin may occur.
These symptoms should not just be attributed to "normal swelling. An early evaluation may help determine the root cause and make the condition less complicated to deal with.
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Treatment will depend on the severity of the disease and its etiology. Treatment usually involves compression garments, special physiotherapy, gentle lymphatic massage, exercises and skin care. The techniques may be used to help decrease swelling and movement.
Surgery may be necessary in some cases of more severe or chronic lymphedema. New pathways can be created to allow the excess fluid to pass, such as in a lymphovenous bypass. For some patients, a transfer of lymph nodes or liposuction may be an option.
Additionally, for patients who have an increased risk of developing lymphedema, doctors may also recommend preventive measures for individuals who must have some type of cancer surgery. This implies that measures should be taken to ensure protection of the lymphatic drainage before any appreciable swelling occurs.
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If swelling isn't severe, don't wait to get help. If there is any continued or unexplained swelling, there will be a specialist available to give information about the cause of the swelling and what treatment is appropriate.
Patients are provided with a holistic treatment pathway for lymphedema with multiple specialists treating their patients who came together for the diagnosis, rehabilitation and surgical treatment of lymphedema.
Treatment of lymphedema is not all about reducing swelling. The overall aim is to maintain a person's function, ease and independence in their daily activities.
If diagnosed early, and appropriately treated and followed-up, lymphedema can be managed successfully and patients can lead their life with a growing sense of confidence and comfort.
Credit: AI
AIIMS New Delhi has successfully performed its second dual kidney transplant using organs from a marginal donor. The procedure highlighted a strategy that could help make greater use of kidneys that may otherwise be rejected for transplantation.
The procedure was carried out on July 28 by a multidisciplinary team from the Departments of Surgical Disciplines, Nephrology, Anaesthesia, Transplant Immunology and the Organ Retrieval Banking Organisation (ORBO).
The donor was a 70-year-old woman from Command Hospital, Chandimandir, Chandigarh. Because of her advanced age and the marginal characteristics of the donated kidneys, doctors transplanted both kidneys into a single 56-year-old woman.
The organs were transported from Chandigarh to New Delhi by an Army helicopter. According to AIIMS, despite a cold ischaemia time of 12 hours, both kidneys were functioning immediately after transplantation.
The recipient showed no complications after the transplantation and was discharged after 10 days with normal kidney function.
In a conventional kidney transplant, one donated kidney is transplanted into a recipient. Meanwhile, in a dual kidney transplant both kidneys are placed into one patient from the same deceased donor.
The approach is considered when the donor is older or the kidneys have characteristics that suggest that a single kidney may not provide sufficient function.
In simple terms, two kidneys that have lower individual functional capacity may be able to provide adequate overall kidney function when transplanted together.
Research has previously found that dual kidney transplantation can be a viable option for kidneys from older or marginal donors. Transplant teams carefully assess the donor organs and recipient before deciding whether using both kidneys together could provide adequate renal function.
A 2025 analysis comparing single and dual transplantation from marginal donors also highlighted the potential of using kidneys from a deceased donor.
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The milestone comes as India faces shortage of transplantable organs. India recorded 20,138 organ transplants in 2025, crossing the 20,000 mark for the first time, but the number of patients needing transplants remains far higher than the available organs.
Recent reports has also highlight the country's mounting transplant needs that still remain unmet despite its position as one of the world's largest transplant centres by volume.
This makes the ability to safely use organs from older or marginal donors particularly important.
“Dual kidney transplantation from carefully selected marginal donors represents an important strategy for increasing the utilization of deceased-donor organs,” AIIMS said in the press release.
AIIMS said the successful transplant demonstrates its efforts to “maximize the utilization of marginal donor organs” and help patients with end-stage kidney disease receive organs at the earliest.
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The immediate functioning of both kidneys despite around 12 hours of cold storage is certainly encouraging. However, the patient’s discharge with normal kidney function represents an early outcome.
Longer follow-up will be needed to determine how well the transplanted kidneys perform over the months and years ahead.
The AIIMS team was led by Prof. Asuri Krishna, with support from the nephrology, anaesthesia, transplant immunology, ORBO and organ retrieval teams.
Credit: AI
It is a common belief that metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease (NAFLD)—is primarily associated with diet, sedentary lifestyles, and obesity. However, there are other factors as well affecting this aspect. Post-menopausal women experience a significantly higher incidence and faster progression of fatty liver disease, even when maintaining a stable body weight.
In pre-menopausal women, oestrogen plays a central role in metabolism, by promoting healthy fat accumulation in subcutaneous tissue (below the skin) rather than around internal organs, it also increases insulin sensitivity and suppresses liver inflammation.
After menopause when oestrogen levels drop, this protective function is lost, there is redistribution of fat leading to more fat accumulation around internal organs including liver thus leading to increase chances of NAFLD and also increasing insulin resistance, needless to say that with age our metabolic rate also goes down which also plays a role in this.
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The important part lies not only in understanding above but to go further in early detection and prevention of menopause associated NAFLD. As we know that fatty liver is a silent disease and often does not causes any signs and symptoms till very advanced stage.
First and foremost is to change lifestyle with advancing age, changing both the dietary habits and physical activity. Regular screening and monitoring is warranted with blood tests, routine metabolic panels, keeping a tab on weight, sugar and cholesterol levels and a basic ultrasound of abdomen.
For someone already diagnosed with 2nd or 3rd stage fatty liver, a simple non-invasive. Fibroscan can help monitor and assess the response to treatment.
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Coming to treatment part of NAFLD in post-menopausal women, it being primary a lifestyle disease so the core of management also lies around managing lifestyle. Medicines are available for treating and controlling NAFLD in conjunction with lifestyle management.
Hormone replacement therapy (HRT), when initiated early in post-menopausal women for symptomatic relief may offer secondary benefits by maintaining metabolic health. However HRT should always be initiated after proper evaluation and expert guidance.
NAFLD is a silent epidemic and primarily a life style disease, knowing about it and knowing triggering and precipitating factors helps understanding and prevention better.
Menopause being a natural biological phenomenon in every female’s life, it becomes essential for us to know how it affects our liver health and overall health as well.
By Mr. Ankur Garg, Group Director Liver Transplant & GI Surgery, Paras Health, Gurgaon
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