Abstract
BackgroundA newspaper article in August 2016 reported that about 40 medical facilities refused dialysis to a human immunodeficiency virus (HIV) patient. Infection Survey Subcommittee in the Japanese Society for Dialysis Therapy investigated this situation.MethodsAn anonymous questionnaire survey about the acceptance of HIV-positive patients was sent to 4039 dialysis institutions. The questionnaire included a number of HIV-positive patients on dialysis currently and in the last 5 years, details on whether the institution received requests to perform dialysis on HIV-positive patients, the responses to these requests, the preparation system for acceptance, the reasons for refusal of dialysis of HIV-positive patients, knowledge of HIV-related guidelines in use, and the considerations for the acceptance of dialysis for HIV-positive patients. We evaluated answers to these questions from the institutions.ResultsTwo thousand five hundred eighty-three facilities (64.0%) responded to the survey questions. In the past 5 years, 215 facilities (8.3%) were requested to accept HIV patients for dialysis and 40.1% of these refused acceptance. Although manuals, written policy and procedure, for a needle piercing accident existed in most of the facilities that accepted the patients, many facilities did neither prepare the stocks of anti-HIV drugs nor cooperate with HIV core hospitals. Principal reasons for the refusal were listed as the lack of medical experience with HIV patients, anxiety of healthcare providers with regard to HIV infection risk, lack of stocks of anti-HIV drugs for needle piercing accidents, and the lack of cooperation with HIV core hospitals. The proportion of facilities expected to accept HIV patients in the future was as low as 16.9% among all facilities that responded to the survey.ConclusionsThe Japanese Society for Dialysis Therapy will need to strengthen the cooperation with other academic societies and disseminate basic knowledge on HIV and infection control measures to develop and establish the acceptance system of maintenance dialysis for HIV patients.
Highlights
A newspaper article in August 2016 reported that about 40 medical facilities refused dialysis to a human immunodeficiency virus (HIV) patient
The AIDS Surveillance Committee of Ministry of Health, Labour and Welfare in Japan reported that the cumulative number of patients infected with human immunodeficiency virus (HIV) was 27,443 in 2016, which is increasing with new registrations of approximately 1500 patients every year [1]
An anonymous questionnaire survey about the acceptance of HIV-positive patients was sent to 4039 dialysis institutions including hospitals and clinics, which were registered as member institutions of the Japanese Society for Dialysis Therapy in November 2016
Summary
A newspaper article in August 2016 reported that about 40 medical facilities refused dialysis to a human immunodeficiency virus (HIV) patient. The AIDS Surveillance Committee of Ministry of Health, Labour and Welfare in Japan reported that the cumulative number of patients infected with human immunodeficiency virus (HIV) was 27,443 in 2016, which is increasing with new registrations of approximately 1500 patients every year [1]. Chronic kidney disease in HIV patients, known as HIV-CKD, is considered one of these examples. The increase in number of HIV-CKD patients is predicted to result in an increase in number of patients requiring maintenance dialysis in near future. The shocking article from the “Tokyo Shimbun” on 30th of August in 2016 reported that a HIV-positive patient requiring hemodialysis was refused maintenance dialysis by about 40 medical institutions
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