Nationwide surveillance of AIDS-defining illnesses among HIV patients in Japan from 1995 to 2017

被引:7
作者
Tanaka, Takeshi [1 ]
Oshima, Kazuhiro [2 ]
Kawano, Kei [1 ]
Tashiro, Masato [1 ,3 ]
Tanaka, Akitaka [1 ]
Fujita, Ayumi [1 ]
Tsukamoto, Misuzu [4 ]
Yasuoka, Akira [5 ]
Teruya, Katsuji [6 ]
Izumikawa, Koichi [1 ,3 ]
机构
[1] Nagasaki Univ Hosp, Infect Control & Educ Ctr, Nagasaki, Nagasaki, Japan
[2] Nagasaki Goto Chuoh Hosp, Dept Internal Med, Goto, Nagasaki, Japan
[3] Nagasaki Univ, Dept Infect Dis, Grad Sch Biomed Sci, Nagasaki, Nagasaki, Japan
[4] Hokusho Cent Hosp, Dept Internal Med, Sasebo, Nagasaki, Japan
[5] Omura Municipal Hosp, Div Internal Med, Omura, Nagasaki, Japan
[6] Ctr Hosp Natl Ctr Global Hlth & Med, Dept AIDS Clin Ctr, Shinjuku Ku, Tokyo, Japan
来源
PLOS ONE | 2021年 / 16卷 / 08期
关键词
ANTIRETROVIRAL THERAPY; INFECTED PATIENTS; INITIATION; MORTALITY; DISEASE; TRIAL;
D O I
10.1371/journal.pone.0256452
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objectives The accurate prevalence of acquired immunodeficiency syndrome (AIDS)-defining illnesses (ADIs) in human immunodeficiency virus (HIV)-infected patients has not been well investigated. Hence, a longitudinal nationwide surveillance study analyzing the current status and national trend of opportunistic complications in HIV-infected patients in Japan is warranted. Methods A nationwide surveillance of opportunistic complications in HIV-infected patients from 1995 to 2017 in Japan was conducted. An annual questionnaire was sent to 383 HIV/AIDS referral hospitals across Japan to collect information (CD4+ lymphocyte count, time of onset, outcome, and antiretroviral therapy [ART] status) of patients diagnosed with any of 23 ADIs between 1995 and 2017. Results The response and case capture rates of the questionnaires in 2017 were 53% and 76%, respectively. The number of reported cases of opportunistic complications peaked in 2011 and subsequently declined. Pneumocystis pneumonia (38.7%), cytomegalovirus infection (13.6%), and candidiasis (12.8%) were associated with the cumulative incidence of ADIs between 1995 and 2017. The mortality rate in HIV-infected patients with opportunistic complications substantially decreased to 3.6% in 2017. The mortality rate was significantly higher in HIV patients who received ART within 14 days of diagnosis of complications than in those who received ART 15 days after diagnosis (13.0% vs. 3.2%, p < 0.01). Conclusions We have demonstrated a 23-year trend of a newly diagnosed AIDS status in Japan with high accuracy. The current data reveal the importance of Pneumocystis pneumonia as a first-onset illness and that early initiation of ART results in poor outcomes in HIV patients in Japan.
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页数:13
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