Abstract
BACKGROUND: Trends in the numbers of Japanese patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) reported to the HIV/AIDS surveillance system in Japan were examined. We attempted to estimate the cumulative number of Japanese with HIV, including people with HIV not reported to the surveillance.METHODS: Data from the HIV/AIDS surveillance in Japan up to the end of 2002 were available. The number of unreported HIV cases was estimated using the back-calculation method. To evaluate this method, the number of reported HIV cases up to 1996 (before highly active antiretroviral treatments were widely available in Japan) was compared with the number estimated by the same method.RESULTS: The number of AIDS cases who were initially reported as having AIDS without having been reported as HIV-infected markedly increased as did the number of reported HIV cases. The number of AIDS cases who had been initially reported as HIV-infected and who were then reported as AIDS progression increased up to 1996 but decreased in the period of 1997-2002. The cumulative number of people with HIV at the end of 2002 was estimated as 14,000, which was 4.2 times higher than the number of reported HIV cases. The cumulative number of HIV cases reported up to 1996 was nearly equal to the number estimated by the above-mentioned method.CONCLUSIONS: HIV infection would appear to be spreading widely among Japanese population. The number of HIV cases actually reported to surveillance might still be low.
Highlights
Trends in the numbers of Japanese patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) reported to the HIV/AIDS surveillance system in Japan were examined
The number of AIDS cases who were initially reported as having AIDS without having been reported as HIV-infected markedly increased as did the number of reported HIV cases
The number of HIV cases reported to surveillance might still be low
Summary
The number of unreported HIV cases was estimated using the back-calculation method To evaluate this method, the number of reported HIV cases up to 1996 (before highly active antiretroviral treatments were widely available in Japan) was compared with the number estimated by the same method. The annual trends in the numbers of Japanese HIV cases reported to surveillance and AIDS cases initially reported up to the end of 2002 were examined using the data of Form 1. The numbers of secondarily reported AIDS cases up to 1996 and in 1997-2002 (when highly active antiretroviral treatments were widely available in Japan) were compared with their numbers expected under the condition that HIV cases received no active antiretroviral treatments. We assumed that under this condition, each reported HIV case had the expected cumulative probability of AIDS progression over a 20-year period previously reported: 0.00, 0.005, 0.03, 0.09, 0.15, 0.22, 0.29, 0.36, 0.43, 0.50, 0.54, 0.58, 0.62, 0.66, 0.70, 0.74, 0.78, 0.82, 0.86 and 0.90 at 1-20 years after HIV infection, respectively. 12 Under the assumption, the expected number of AIDS cases progressed from reported HIV cases was calculated as the total of the expected cumulative probability of AIDS progression for such cases corresponding to the elapsed years after their report of HIV infection
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