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
Colorectal cancer (CRC), a term encompassing cancer of the colon and rectum, is not only a growing burden in India, but a significant proportion of patients are now being diagnosed at a young age. While colorectal cancer is more common in older adults, Indian clinical studies have identified the phenomenon of young onset colorectal cancer (YO-CRC), typically diagnosed before the age of 50. An experts’ review on epidemiology of colorectal cancer with special emphasis on India, an article in 2025 was published in the Indian Journal of Gastroenterology. The review found that there has been an annual rise of 2-3% in the incidence of colorectal cancer over the past two decades.
In the area of Young Onset Colorectal Cancer, an editorial in 2024 in the South Asian Journal of Cancer noted that one quarter to one-third of colorectal cancer patients in India were below 40 years, and many were diagnosed at stage III or IV. Titled Clinicopathologic Profile and Treatment Outcomes of Colorectal Cancer in Young Adults, A Multicenter Study from India, an article published in JCO Global Oncology studied colorectal cancer among adolescents and young adults. The study revealed 62.70% had colon cancer and 37.30% rectal cancer, with 67% being aged 30-39 years and no significant gender predisposition, though females had a higher metastatic burden.
There is no single explanation. Researchers have studied factors like dietary changes, obesity, physical inactivity, altered metabolism, alcohol consumption, smoking, and environment as possible contributors. Increasing urbanisation and changing food habits could also be playing a role in India’s shifting colorectal cancer profile. But not all patients present with conventional risk factors, and in many patients, the causes remain unclear.
Genetic predispositions need special mention. Conditions such as Lynch syndrome and familial adenomatous polyposis (an inherited genetic condition that causes precancerous polyps to form in the large intestine) can raise the risk of colorectal cancer at a young age, but most young-onset cases are not explained by an inherited cancer syndrome.
One of the biggest problems in cancer treatment is delayed diagnosis. Because cancer is associated with older age, the symptoms in younger people may be mistaken for piles, constipation, diet-related problems or even irritable bowel syndrome. Rectal bleeding, persistent changes in bowel habits, unexplained weight loss, abdominal pain, iron-deficiency anaemia, persistent fatigue, or a feeling of incomplete bowel evacuation is usually dismissed as minor issues in younger people.
Colonoscopy is not a solution that can be recommended for every young adult. Symptoms- and risk-based screening is a more reasonable approach. People with persistent symptoms, a strong family history of colorectal cancer, hereditary cancer syndromes, inflammatory bowel disease, or unexplained anaemia may require more intensive evaluation (including colonoscopy) if clinically indicated. This are high risk group, and they need regular screening lifelong. India’s colorectal cancer burden is rising, and younger patients are important segment of this burden.
The evidence available does not prove a nationwide explosion of colorectal cancer in under-50 age groups in India, but it does demonstrate an increasing overall incidence, a significant presence of young onset colorectal cancer, and frequent late presentation. If someone have a first degree relative with colon or rectal cancer like parents, ideally, they should have a colonoscopy done by the age of 45. For younger Indians, early recognition of warning signs may be one of the most critical steps for timely diagnosis and improved outcomes.
By Dr. Abhishek Gangopadhyay, Consultant - Surgical Gastroenterology, Surgical Oncology, Narayana RN Tagore Hospital, Mukundapur, Kolkata
Credit: iStock
At 42, Danielle Ripley-Burgess of Kansas City, Missouri, has survived colon cancer three times, at 17, 25 and 39.
The disease often begins as noncancerous growths called polyps in the colon or rectum. Early-stage cancer and precancerous polyps may cause no noticeable symptoms. Ripley-Burgess spotted her first symptom at the age of 14 but ignored.
At 14, Ripley-Burgess noticed specks of blood in her stool but hid them out of embarrassment, believing red foods might be responsible.
“I thought, I’m eating something red and that’s probably what I see,” she told Today. “So I put myself on a ‘no red foods diet’ and stopped eating anything that was red in color: everything from candy to pizza to salsa to raspberry popsicles.”
After two years she eventually told her mother, who believed it to be a case of hemorrhoids. As her bleeding worsened, and she developed fatigue and severe stomach pain, she was taken to a gastroenterologist.
A few weeks after her 17th birthday, Ripley-Burgess was diagnosed with stage 3 colon cancer. She underwent chemotherapy, radiation and surgery. But years later, a follow-up colonoscopy revealed another cancerous polyp.
“I thought I had beaten cancer. I was getting colonoscopies every three years, and after one of them, I woke up and saw the very same look on the doctor’s face that I had seen eight years prior,” she said. “He saw a polyp that later turned out to be cancerous. I had no symptoms. At 25, I had stage 1 colon cancer.”
The second diagnosis was emotionally difficult as she feared losing the life she had built with her husband and the future they had planned.
Further testing revealed that Ripley-Burgess had Lynch syndrome, an inherited condition that increases the risk of colorectal, uterine and other cancers, according to the Mayo Clinic.
She underwent a preventive hysterectomy and subtotal colectomy, which removed all but about 13 inches of her colon.
Despite these measures, a colonoscopy in 2023 yet again detected a recurrence. At 39, she opted to have the remaining colon removed and a permanent ileostomy.
“I wasn’t expecting it, but I also wasn’t completely shocked,” she said, explaining that living with Lynch syndrome meant knowing cancer could return.
Ripley-Burgess now shares her story to encourage people, especially younger adults, to seek medical attention for unusual symptoms.
“If I could go back and tell my younger self something, it would be: Don’t be embarrassed about your body,” she told the outlet. “If you’re seeing something with your body that’s uncomfortable and weird, and you’re not ready yet to tell a doctor, tell somebody — a friend or family member. Don’t sit in that place of: something is wrong with your body, and you don’t know what it is. Don’t sit there alone. Don’t downplay what you’re seeing,” she
Colorectal cancer is expected to cause 158,850 new cases and 55,230 deaths in the US in 2026, according to the American Cancer Society.
Dr. Sajjan Rajpurohit, medical oncologist at BLK-Max Super Speciality Hospital, said, “Blood in the stool is one of the most common and concerning signs. While it might be due to hemorrhoids or fissures, it’s important not to assume. A proper evaluation is critical.”
Rectal bleeding can have several causes, but it should not automatically be attributed to hemorrhoids. Timely medical evaluation can help identify the cause and ensure appropriate treatment.
Credit: iStock
Six unvaccinated people, including children, have died from measles in the US this year. As of October 8, the country had reported 4,080 confirmed cases, according to the Centers for Disease Control and Prevention (CDC).
Measles spreads easily through the air and can remain infectious for up to two hours. Symptoms include high fever, cough, runny nose, red, watery eyes, and a rash that typically starts on the face. Infected people can spread the virus before the rash appears.
Two doses of the measles, mumps, and rubella (MMR) vaccine are approximately 97% effective against measles and remain the best protection against the disease and its complications.
Also read: Sixth Measles-Associated Death Reported In Pennsylvania As Cases Cross 1,100
Measles also causes pneumonia, brain inflammation, and death. Some complications emerge weeks or years after the initial infection.
Three serious consequences are acute disseminated encephalomyelitis (ADEM), immune amnesia, and subacute sclerosing panencephalitis (SSPE).
According to the CDC, one to three out of every 1,000 children with measles die from respiratory and neurological complications.
An 18-year-old from Mifflin County, Pennsylvania, died from acute disseminated encephalomyelitis (ADEM), reported as the state's fourth measles-associated death this year.
ADEM causes inflammation in the brain and spinal cord when the immune system mistakenly attacks nervous system tissue. It can develop weeks after infections such as measles or influenza.
Symptoms include weakness, confusion, vision problems, and seizures. Severe cases can be fatal.
ADEM occurs in approximately one out of every 1,000 measles cases. Treatment may include steroids, intravenous immunoglobulin, and plasma exchange.
Most patients recover, but lasting problems can include motor weakness, cognitive impairment, seizures, and vision loss. In a 2022 study of 77 children with moderate to severe ADEM, nearly a quarter had persistent health issues.
Read More: Measles Cases Are Rising in US—Who Should Get A Booster Shot?
Measles can destroy immune cells that remember previously encountered pathogens, weakening protection built through past infections and vaccinations. This is known as immune amnesia.
“Immune amnesia basically destroys your immune system,” said Dr. Stephen J. Elledge, professor of genetics and medicine at Harvard Medical School. “It infects and kills the cells that store immune memories — plasma cells, B cells, and T cells. It’s like burning down a library full of immunological knowledge.”
A 2019 study published in Science, co-authored by Elledge, found that measles could erase up to 73% of a person's antibody repertoire.
This loss can leave people vulnerable to infections their immune systems had previously learned to fight. Research published in 2015 suggested that rebuilding immune protection can take two to three years.
Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological disease caused by a persistent measles virus infection in the central nervous system.
SSPE is "the most enigmatic and terrifying consequence of measles", Andrew Pavia, MD, a pediatric infectious disease epidemiologist at the University of Utah, told CIDRAP News.
Symptoms may appear seven to 10 years after measles, even in people who initially recover. Early signs include personality changes, mood swings, and headaches. The disease can progress to involuntary movements, seizures, vision loss, cognitive decline, coma, and death.
There is no known cure, and SSPE is ultimately fatal.
Children who contract measles during infancy face a particularly high risk of SSPE.
The CDC estimated that seven to 11 out of every 100,000 people infected during the US measles resurgence of 1989–1991 were at risk of developing the disease.
A 2016 review of California health records estimated that SSPE occurred in approximately one out of every 609 children who contracted measles before 12 months of age.
A child in Los Angeles died of SSPE last year after contracting measles as an infant, before becoming eligible for the MMR vaccine. In the United States, the first dose is generally recommended at 12 to 15 months.
With measles cases continuing to rise, Pavia warned that SSPE "is a potential time bomb."
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