Miyazaki Naoko, Sugiura Wataru, Gatanaga Hiroyuki, Watanabe Dai, Yamamoto Yasuyuki, Yokomaku Yoshiyuki, Yoshimura Kazuhisa, Matsushita Shuzo
The Institute of Medical Science, The University of Tokyo.
Jpn J Infect Dis. 2017 Mar 24;70(2):158-160. doi: 10.7883/yoken.JJID.2015.599. Epub 2016 Jun 30.
We investigated the effectiveness of the Japanese health care system for human immunodeficiency virus/acquired immunodeficiency virus (HIV/AIDS), in terms of prevention, diagnosis, access to antiretroviral treatment, and treatment outcomes. Clinical information on HIV/AIDS cases was collected via questionnaires sent to 377 registered HIV/AIDS clinics in Japan. Data on 9,040 and 14,569 cases were collected in 2009 and 2014, respectively. The percentages of cases undergoing treatment were 69.6% and 87.8% in 2009 and 2014, respectively, demonstrating an improvement in treatment coverage over the 5 years between the 2 surveys. The proportion of cases with undetectable HIV RNA in the 2014 survey was 87.7%. Thus, our survey revealed that the 2 of the United Nations AIDS Fast-Track targets, 90% treated and 90% virally suppressed, are close to being achieved. However, Japan appears to have fallen short of the upstream target of 90% diagnosed. Japan needs to radically reform its strategies for encouraging people to undergo HIV testing and to develop a system for estimating the number of people living with HIV.
我们从预防、诊断、获得抗逆转录病毒治疗以及治疗结果等方面，调查了日本医疗保健系统针对人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）的有效性。通过向日本377家注册的HIV/AIDS诊所发送问卷，收集了HIV/AIDS病例的临床信息。2009年和2014年分别收集了9040例和14569例的数据。2009年和2014年接受治疗的病例百分比分别为69.6%和87.8%，表明在这两次调查间隔的5年中，治疗覆盖率有所提高。在2014年的调查中，HIV RNA检测不到的病例比例为87.7%。因此，我们的调查显示，联合国艾滋病快速通道的两个目标，即90%的患者接受治疗和90%的患者病毒得到抑制，已接近实现。然而，日本似乎未达到90%的患者得到诊断这一上游目标。日本需要从根本上改革其鼓励人们接受HIV检测的策略，并建立一个估计HIV感染者人数的系统。
