Abstract
The CD4 cell count of patients during diagnosis and distribution of CD4 cell counts in the patient population are important to understand infection-diagnosis interval and incidence rate of human immunodeficiency virus (HIV) infection, respectively. However, this information has not been published in Japan. This study aimed to describe the change in CD4 cell count trends and clarify the change in patients' characteristics in association with the CD4 cell count information. A descriptive study was conducted to analyze the medical records of patients with HIV who visited one of the largest acquired immunodeficiency syndrome (AIDS) core hospitals in western Japan. The basic characteristics, CD4 cell counts, viral loads, and diagnosis-treatment intervals between the first (2003-2010) and second (2011-2017) halves of the study duration were compared. The distribution of CD4 cell counts significantly changed between 2003-2010 and 2011-2017 (χ2 = 20.42, P < 0.001). The proportion of CD4 cell count <200 cells/mm3 increased (38.8% in 2003 to 45.9% in 2017), whereas CD4 cell count ≥500 cells/mm3 decreased (19.4% in 2003 to 12.2% in 2017). Moreover, the distributions of age groups, history of HIV screening test, patient outcomes, HIV viral load, and diagnosis-treatment interval also significantly changed (χ2 = 25.55, P < 0.001; χ2 = 8.37, P = 0.015; χ2 = 6.07, P = 0.014; χ2 = 13.36, P = 0.020; χ2 = 173.76, P < 0.001, respectively). This study demonstrated the fundamental trends of the HIV epidemic in Osaka, Japan between 2003-2010 and 2011-2017 and indicated that the incidence rate of HIV was decreasing in Japan.
Highlights
The reported number of new cases of human immunodeficiency virus (HIV) infection in Japan reached its peak in 2013 and has been decreasing gradually,[1] suggesting a decrease in the incidence rate of recent HIV infection
The diagnosis of HIV infection gets delayed largely because of its clinical and epidemiological features, such as: (i) mild=nonspecific symptoms or even no symptom during the acute stage among patients,[2] (ii) asymptomatic HIV infection until clear symptoms are developed at the acquired immunodeficiency syndrome (AIDS) stage,[3] and (iii) less number of patients with HIV who get the serological tests done in its latent period.[4]
Design and data source This was a descriptive study of CD4 cell count data among patients with HIV at one of the largest AIDS core hospitals in western Japan
Summary
The reported number of new cases of human immunodeficiency virus (HIV) infection in Japan reached its peak in 2013 and has been decreasing gradually,[1] suggesting a decrease in the incidence rate of recent HIV infection. The CD4 cell count of patients during diagnosis and distribution of CD4 cell counts in the patient population are important to understand infection-diagnosis interval and incidence rate of human immunodeficiency virus (HIV) infection, respectively. This information has not been published in Japan. This study aimed to describe the change in CD4 cell count trends and clarify the change in patients’ characteristics in association with the CD4 cell count information
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