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.

Common metabolic conditions such as obesity and diabetes are increasingly becoming a serious public health concern in India. Their health implications extend beyond the conditions themselves, with obesity and diabetes associated with a range of chronic diseases and complications that can affect long-term health and wellbeing. As lifestyles become more sedentary and the prevalence of these conditions continues to rise, understanding their wider implications on women’s health is becoming increasingly important.

What many women may not realize is that this metabolic burden can carry a deeper, less visible consequence one that reaches into the domain of gynecological cancer.

One such concern is endometrial cancer. A form of uterine cancer, it develops in the lining of the uterus and is becoming an increasingly important health issue globally. Yet, many women remain unfamiliar with the disease, its risk factors, and the symptoms that require prompt medical attention.

The Metabolic Health Connection

Increasing evidence points to a link between metabolic syndrome and endometrial cancer, particularly through conditions such as obesity and diabetes. Excess body weight and metabolic disturbances can disrupt hormonal balance, such as by increasing estrogen production without a corresponding increase in progesterone. Over time, this hormonal imbalance may stimulate abnormal growth of the endometrial lining, increasing the likelihood of cancer development.

Diabetes, too, has been associated with an increased risk. As obesity and diabetes become more prevalent, recognizing these less-discussed consequences is an important part of strengthening women’s preventive health.

For women, maintaining a healthy weight, staying physically active, managing metabolic conditions effectively and paying attention to unusual symptoms can all form part of a broader approach to preventive health.

Watching Out For Unusual Symptoms

One of the most important characteristics of endometrial cancer is that it often presents with abnormal vaginal bleeding. Bleeding or spotting after menopause is one of the most significant warning signs and should never be ignored.

For women who have not reached menopause, heavier-than-normal periods, prolonged bleeding, or bleeding between periods should be discussed with a healthcare professional.

Why Awareness Matters

Improving awareness is important because there is currently no recommended routine screening test for endometrial cancer in asymptomatic women. As a result, recognizing symptoms and seeking timely medical advice are among the most effective ways to support earlier diagnosis.

At the same time, the conversation should not end with cancer awareness alone. As India continues to face a growing burden of obesity and diabetes, prioritizing metabolic health has become increasingly important for overall wellbeing.

Maintaining a healthy weight, staying physically active, eating a balanced diet, and effectively managing conditions such as diabetes can help reduce the risk of a range of serious health complications, including certain cancers. For women, understanding the connection between metabolic health and endometrial cancer can empower more informed decisions about prevention, symptom recognition, and long-term health. By addressing obesity and diabetes early and seeking medical advice when unusual symptoms arise, women can take meaningful steps towards protecting their health at every stage of life.

(By Dr. Shefali Sardana, Medical Oncologist, Apollo Hospitals, New Delhi)

Melanoma is often considered one of the more challenging cancers to treat, particularly when it has spread to distant organs. For early-stage disease, surgery remains an important treatment option. But once melanoma reaches stage IV, treatment becomes considerably more complex.

Understanding The Biology Of Advanced Melanoma

According to Dr. Mandeep Singh Malhotra, Cheif Mentor AOHC, cytotoxic chemotherapy has traditionally had a limited role in melanoma, while immunotherapy has changed the treatment landscape for many patients.

When melanoma is detected at an early stage and can be completely removed, surgery is generally considered the preferred treatment. Depending on the disease, this can involve removal of the primary tumour and assessment or treatment of regional lymph nodes.

But stage IV melanoma presents a very different challenge.

A Complex Case With Multiple Tumour Sites

Dr. Malhotra recalls the case of Sarah, who came to the team with multiple nodules in the scapular region. There were also lesions on both legs and a lesion in the pancreas. So there were multiple nodules. One in the right side of the leg, another in the left side of the leg. And there was a lesion in the pancreas.

Rather than relying on a standard treatment approach alone, the team first tried to understand the biology of the disease. As a standard protocol for this type of case, we first try to understand the disease biology. In Sarah’s case, the team used extensive testing, including chemosensitivity testing, transcriptomic analysis and next-generation sequencing.

Also read: Cancer Should Be Made Notifiable In India, Say Experts: Here’s Why

When Imaging Initially Suggests Progression

The results suggested sensitivity to certain drugs. When we analysed those reports, we were able to understand that cytotoxic drugs like temozolomide were effective. And checkpoint inhibitors like pembrolizumab, nivolumab were effective.

Based on these findings, the team developed a treatment protocol in which the main component was an immune checkpoint inhibitor along with low-dose temozolomide. Other agents, including lower doses of anti-VEGF, anti-FGF and CDK inhibitors, were also incorporated based on the analysis.

After around four weeks, the response became difficult to interpret on imaging. The PET scan suggested that all the lesions have had a pseudo progression.

Pseudo progression is a recognised phenomenon during immunotherapy. A tumour may appear larger initially because of immune-cell infiltration, even when the treatment is actually producing an anti-tumour response.

This is particularly relevant in melanoma treated with immune checkpoint inhibitors. However, doctors cannot simply assume that every apparent progression is pseudo-progression; true progression must also be considered and confirmed through Histopathology

Also read: French Court Links Flight Attendant’s Breast Cancer To Workplace Radiation; How Does Flying Increase Cancer Risk?

Histopathology Reveals A Dramatic Treatment Response

The team then proceeded with surgery, removing the nodules from the scapular region and both thighs. The specimens were sent for histopathological examination. And histopathology results were amazing. The tumours had gone necrotic.

The pathology showed extensive treatment-related changes, with inflammation and fibrosis around the nodules and only small areas containing viable melanoma cells.

Also read: _{Daraxonrasib: US FDA Approves Once-Daily Pill for Metastatic Pancreatic Cancer}

What Comes Next For The Patient?

For now, the plan is to continue the treatment for a few more cycles and then reassess the pancreatic lesion. The team is considering NanoKnife (irreversible electroporation) for the pancreatic lesion followed by Vaccines.

Certain cancer vaccines are being developed in certain labs in Germany and Europe and they are available for our patients in India on compassionate grounds. It's a very, very good response. And to achieve disease NED in stage four melanoma, I think we are really lucky and it's all due to the grace of God.

Why Individualised Treatment Matters In Stage IV Disease

The case also highlights an important point about advanced melanoma: treatment may need to be individualised according to the biology of the disease and the patient's response. At the same time, he stresses the need for hope. I hope that more people can benefit from this protocol and use this protocol to treat melanomas across the world.

For Sarah, the journey is still ongoing. The next step will be to reassess the pancreatic lesion and determine whether further local treatment can help achieve no evidence of disease (NED). A stage IV melanoma involving multiple sites, including the pancreas, reaching a point where NED may become a possibility is certainly an encouraging development. But it remains an individual clinical experience, rather than proof that the same protocol will work for every patient with metastatic melanoma.

By Dr. Mandeep Singh Malhotra, Director of Surgical Oncology at CK Birla Hospital and Chief Mentor at AOHC

People living with obesity and diabetes often feel healthy in their day-to-day life, but some of the most dangerous changes may be happening silently inside their bodies.

The liver is one of the first organs to be affected. In many cases, fat slowly accumulates in the liver without causing any pain, discomfort, or obvious symptoms. This is why fatty liver disease is often called a “silent condition.” By the time it is detected, it may already have progressed to an irreversible stage.

Excess body fat, particularly around the abdomen, disrupts how the body processes sugar and fats, placing continuous stress on the liver. Because of this silent progression, experts now strongly recommend that people living with obesity and type 2 diabetes should proactively check their liver health, even when they feel completely well.

Obesity is closely linked with liver damage through a series of metabolic changes that develop over time. When the body becomes resistant to insulin, fat begins to accumulate in liver cells, triggering inflammation and gradual injury.

If this continues unchecked, the condition can progress from simple fat accumulation to more serious stages, including metabolic dysfunction-associated steatohepatitis (MASH), where inflammation and liver cell damage become more significant.

Over time, this may lead to fibrosis (scarring of the liver), and in advanced cases, cirrhosis, which can severely affect liver function. Further, patients with fatty liver may directly present with liver cancer, which can occur in up to 20% of patients.

How Common Is Fatty Liver In People With Diabetes And Obesity?

In India, the burden of metabolic dysfunction-associated steatotic liver disease (MASLD) or fatty liver is rising and is now recognised as a common metabolic condition. Studies from the Indian subcontinent estimate that 1 in 3 people may have MASLD. Fatty liver is particularly common among individuals with metabolic risk factors.

It is seen in nearly 40–80% of people with type 2 diabetes and 30–90% of those with obesity, often without clear symptoms.iv Hospital-based trends also suggest increasing detection in younger age groups, reflecting changes in diet, reduced physical activity, and more sedentary lifestyles.

Also read: Post-Menopausal Women Face A Higher Risk Of Fatty Liver Disease: How Falling Estrogen Levels Impact Liver Health

What Liver Checks And Preventive Measures Should You Follow?

Preventive measures to be followed:

• If you live with excess weight/obesity and type 2 diabetes or PCOS (polycystic ovarian syndrome) or dyslipidemia, seek early consultation with a physician or hepatologist.

• Your doctor may request routine metabolic screening:

• Regular liver function tests as part of annual health check-ups

• Ultrasound screening for individuals with obesity or diabetes

• Monitoring blood sugar, cholesterol, and triglyceride levels

• Liver scarring scan (annually for patients with diabetes/obesity)

• Avoiding long-term neglect of “mild” or borderline test results

Also read: From Liver Inflammation to Cancer: When Hepatitis Becomes a Serious Warning Sign

With rising obesity rates in India, early liver screening should become a routine part of preventive healthcare. Even modest weight reduction, improved diet quality, and regular exercise (approximately 150 minutes per week of moderate-intensity exercise (example: brisk walking, gardening, swimming, cycling) or 75 minutes of vigorous exercise (example: weight training) can significantly reduce liver fat and inflammation within 3-6 months.

However, once the disease progresses to MASH or fibrosis, reversal becomes more difficult and may require long-term medical management. Early-stage fatty liver disease is reversible in many cases. In fact, medications can even reverse liver fibrosis (early scarring), but in only 25% of patients. Simple homemade food is sufficient to prevent these lifestyle diseases, and there is no need for “fancy online diets or supplements”.

Our forefathers lived longer by consuming homemade food and water without any supplements. Newly approved therapies such as semaglutide (GLP1 analogues) have been shown to resolve steatohepatitis and reduce liver fibrosis. These liver benefits do not appear to be explained solely by weight loss, suggesting a broader potential impact on liver health.

The absence of symptoms does not mean the absence of risk. Taking care of the liver early is not just about preventing disease; it is about protecting long-term health, energy, and quality of life.

By Dr. Anand V. Kulkarni, Senior Consultant Hepatologist & Director – Critical Care Hepatology, AIG Hospitals, Hyderabad