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.
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With flu season setting in across countries, including the US and the UK, doctors are urging people to get their annual flu shots. October offers an opportunity to build protection before winter flu activity increases.
The UK Health Security Agency (UKHSA) reported above-average flu activity and urged at-risk groups to get vaccinated. England's flu vaccination program last winter is estimated to have prevented about 100,000 hospital admissions and 7,000 deaths.
The US Centers for Disease Control and Prevention (CDC) recommends annual flu vaccination for everyone aged six months and older. The seasonal vaccine targets influenza A(H1N1), A(H3N2) and B/Victoria viruses.
In September, the Indian Medical Association (IMA) also highlighted annual influenza vaccination and gaps in adult immunization.
Also read: Flu Activity Rises Early In US, UK And Japan: Why Experts Urge Vaccination Before Winter
The flu vaccine takes about two weeks to build protection, making October a good time to get vaccinated before winter, Dr. Bhawna Malik, Senior Consultant-Neonatologist and Pediatric Intensivist at Motherhood Hospitals, Greater Noida, told HealthandMe.
In India, flu activity can increase between January and March. Vaccination in October allows time for immunity to develop before this period.
However, October is not the only option. Dr. Vikas Maurya, Senior Director and HOD, Pulmonology, Fortis Hospital, Shalimar Bagh, told HealthandMe that vaccination can also be taken between April and mid-June, ahead of another period of flu activity from July to September.
He said one dose annually is generally sufficient, with timing depending on local flu patterns and the vaccine used.
Healthy adults and children, as well as people with underlying conditions, can benefit from flu vaccination. Influenza can cause pneumonia, hospitalization and other severe complications.
Older adults, particularly those aged 65 and above, and people with diabetes, heart disease, kidney or liver disease, asthma or chronic obstructive pulmonary disease (COPD) face a higher risk of complications.
“Flu vaccination doesn't protect just yourself against the risk of having influenza but it also prevents transmission of infection to other vulnerable people around ourselves like little ones, elderly family members and people with medical conditions,” Dr. Malik said.
Dr. Mohit Bhardhwaj, Consultant, Pulmonology, PB Health, Gurugram, told HealthandMe that annual vaccination helps protect individuals and reduce transmission, as flu viruses change and vaccine protection can decrease over time.
Read More: Flu 2026: Symptoms To Watch For As New Season Begins
The vaccine can be administered from six months of age. The schedule depends on age and previous vaccination history.
Dr. Malik recommends vaccination for parents, siblings and caregivers to help reduce the risk of transmitting influenza to infants who are too young to receive the vaccine.
Most flu vaccine side effects are mild and may include injection-site pain, redness or swelling, fever, headache, body aches and tiredness. These generally settle within a few days, Dr. Bhardhwaj said.
A cooling pack or an ice pack wrapped in cloth may help relieve injection-site discomfort. Nasal vaccines may cause a stuffy nose, cough or headache, Dr. Maurya noted.
The injected flu vaccine cannot cause influenza. Anyone experiencing persistent fever, breathing difficulty or unusual symptoms should seek medical advice. Those with a history of serious allergic reactions to a previous flu vaccine should consult their doctor before vaccination.
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A migraine attack is characterised by nausea, vomiting and sensitivity to light and sound. But early symptoms may surface long before the headache itself. Signs like fatigue, mood changes, food cravings and difficulty focusing may appear hours or even days before the pain.
The symptoms that occur during the attack reflect a complex neurological process that involves several interconnected brain networks, rather than just a headache.
A new Lancet Seminar review, looks deeper into how migraine develops, why its symptoms extend beyond head pain and how the better understanding of its biology are affecting treatment.
The study authors describe migraine as a chronic neurovascular disorder shaped by genetic susceptibility and interactions between the brain’s sensory networks, nerves, and blood vessels.
Also read: These Yoga Asanas Could Cure Your Migraine
Migraine is the result of the interaction of multiple systems responsible for processing sensory information and transmitting pain. Researchers are focusing more on other factors that drive migraine rather than just blood vessel narrowing or widening.
An important concept is the trigeminovascular system, which is a network involving the trigeminal nerve, tissues sensitive to pain that surrounds the brain and blood vessels. When this system gets activated, the patient experiences the peculiar head ache.
Chemical messengers called neuropeptides also play a key role. One of the most important is calcitonin gene-related peptide (CGRP), which participates in pain signalling in migraine. Treatments that target CGRP is an important development in migraine treatment and management.
The condition also involves changes in how the brain processes sensory information. This explains why light, sounds or smells can become intolerable during an migraine attack, and why some patients experience nausea, dizziness or difficulty concentrating along with severe headache.
Not an isolated abnormality triggering every symptom, migraine involves interactive neurological and vascular processes whose contributions can vary between individuals and across different phases of an attack.
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Migraine attacks typically occurs through several phases mostly:
The earliest phase can involve fatigue, yawning, mood changes, food cravings, neck stiffness and difficulty concentrating. The involvement of brain regions linked with homeostasis, including the hypothalamus, may help explain why an approaching attack can affect sleep, appetite, mood and other bodily functions.
Some people experience an aura before or during the headache. This can include flashing lights, zigzag patterns, blind spots, tingling or temporary difficulties with speech. Aura is associated with a phenomenon called cortical spreading depression, a wave of changing electrical activity that moves across the brain’s cortex.
During the headache phase, activation of the trigeminovascular system contributes to pain signalling. Patients may experience moderate-to-severe, often throbbing pain, alongside nausea, vomiting and sensitivity to light, sound or smells.
Movement can aggravate the pain, making routine activities difficult. The headache phase can last several hours to as long as 72 hours.
The end of an attack does not necessarily mean the attack is over. Some people experience exhaustion, dizziness, body aches and difficulty concentrating for hours or days afterwards. These phases can overlap, and their timing and severity differ from person to person.
The Lancet review also highlights the role of genetic and epigenetic factors that contribute to migraine risk. They interact with complex neurological networks, helping explain why some people experience occasional attacks while others develop frequent or chronic migraine.
Episodic migraine is characterised by fewer than 15 headache days per month. Chronic migraine involves headaches on at least 15 days per month for more than three months, including migraine features on at least eight days each month.
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Breast cancer is the most common cancer among women in India. According to various estimates, it accounts for about 26% of all cancers diagnosed among women, with nearly 2,00,000 new cases estimated in India each year.
Family history is an important risk factor, as some women inherit genetic changes that can increase their risk of developing breast cancer. Hereditary breast cancers can result from inherited genetic susceptibility, including mutations in high- or moderate-penetrance genes. BRCA1 and BRCA2 are among the best-known genes associated with hereditary breast cancer. Therefore, knowing family history is important.
But the absence of a family history does not mean that women are free from risk. In fact, around 80-85% of breast cancer cases occur in women with no known family history. These are generally referred to as sporadic cases.
Breast cancer risk factors can broadly be divided into those that cannot be changed and those that can potentially be modified.
Among the non-modifiable factors are age and certain reproductive and hormonal factors. Longer lifetime exposure to hormones such as oestrogen and progesterone can increase breast cancer risk. Early menstruation, later menopause and having a first pregnancy at a later age are some factors associated with longer hormonal exposure.
Potentially modifiable risk factors are largely lifestyle-related and include alcohol consumption, physical inactivity, excess body weight (particularly after menopause) and tobacco exposure. Maintaining a healthy weight, staying physically active, avoiding tobacco and limiting alcohol can help reduce the risk.
Also read: Amanda Peet’s Breast Cancer Wasn’t A Lump: What Was Her First Sign?
The five important warning signs include:
These signs do not automatically mean cancer. But they should not be ignored.
Also read: Mammogram May Spot Hidden Heart Risk That Doctors Miss In Women
If you notice any of these signs, particularly a new or persistent change in your breast, do not ignore it or try to diagnose it yourself. Seek medical evaluation promptly. A doctor will assess the breast and, if necessary, recommend what is known as a triple assessment: a clinical examination, breast imaging such as ultrasound or mammography, and tissue diagnosis when required. In selected cases, an MRI may also be recommended.
Tissue sampling may involve Fine Needle Aspiration Cytology or a core/true-cut biopsy. Together, these assessments help determine whether a breast abnormality is benign or malignant. It is important to distinguish this from screening. Screening is done in women who do not have symptoms, with the aim of detecting breast cancer at an early stage. When a woman has a symptom or notices a new breast change, she needs diagnostic evaluation rather than simply screening.
Finding a lump can understandably cause anxiety. However, most breast lumps, particularly in younger women, are benign. Common causes include fibroadenomas, breast cysts and fibrocystic changes.
Fibrocystic changes are often influenced by hormonal fluctuations. A lump may become more prominent or painful one to two weeks before menstruation and become smaller or less uncomfortable after the period. Some women may also experience a feeling of heaviness or tenderness in the breast.
An injury to the breast can also result in tissue damage and inflammation, producing a lump-like area. Therefore, a lump should not be assumed to be cancer, but neither should it be dismissed without appropriate evaluation.
Early detection can make a significant difference in the successful management of breast cancer. Women should remember that having no family history does not mean they are not at risk. At the same time, a breast lump or other change does not necessarily indicate cancer. The key is to know your own breasts, be aware of the warning signs and seek timely medical evaluation whenever a new or persistent change is noticed.
By Dr Megha B - Surgical Oncologist in Trichy - Breast, GI & Cancer Surgery Specialist, Kauvery Hospital
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