著者

Fumiko Kagiura Ryota Matsuyama Dai Watanabe Yuuki Tsuchihashi Kazuhiko Kanou Takuri Takahashi Yusuke Matsui Masayuki Kakehashi Tomimasa Sunagawa Takuma Shirasaka

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.5, pp.256-261, 2023-05-05 (Released:2023-05-05)

参考文献数

29

被引用文献数

1

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Background: 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.Methods: 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.Results: 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).Conclusion: 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.

著者

Yuuki Tsuchihashi Yuzo Arima Takuri Takahashi Kazuhiko Kanou Yusuke Kobayashi Tomimasa Sunagawa Motoi Suzuki

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200519, (Released:2021-05-29)

参考文献数

40

被引用文献数

6

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BackgroundNotifications of novel coronavirus infections increased in early 2020 in Japan. We described characteristics of novel coronavirus infection cases and analyzed risk factors for severe outcomes.MethodsCases were persons with laboratory-confirmed novel coronavirus infection reported under national surveillance between January and March 2020. Clinical characteristics were described, and factors associated with severe outcomes (intensive care unit [ICU] admission, invasive ventilation/death) were analyzed using Poisson regression.ResultsAmong the 516 cases analyzed, median age was 60 years (range: 1–97 years) and 285 (55%) were male. Common symptoms/signs were fever (375/475, 79%), cough (353/465, 76%), and pneumonia (245/387, 63%). Ten (2%) cases died. Of the 348 cases with data, 50 (14%) required invasive ventilation. Adjusted for each other, male gender and 1-year increase in age were associated with ICU admission (risk ratio (RR) 4.18; 95% confidence interval (CI), 1.69–10.32 and RR 1.05; 95%CI, 1.03–1.08, respectively) and invasive ventilation/death (RR 2.79; 95%CI, 1.49–5.21 and RR 1.06; 95%CI, 1.04–1.08). Diabetes, dyslipidemia, hyperuricemia, and lung diseases were also associated with severe outcomes. Of the 80 cases asymptomatic at hospitalization, 40 developed symptoms and five of them >70 years of age required invasive ventilation.ConclusionsThe early stage of the novel coronavirus epidemic in Japan disproportionately affected the elderly. Older age, male gender, and underlying conditions were associated with severe outcomes. Notably, some elderly case-patients who were asymptomatic at diagnosis and promptly hospitalized still went on to develop severe disease, indicating the importance of careful monitoring of certain populations.