Jpn.J.Infect.Dis., 52, 55-87, 1999

Special Report

Annual Surveillance Report of HIV/AIDS in Japan, 1997

AIDS Surveillance Committee, Ministry of Health and Welfare, Japan
Working Group of Annual AIDS Surveillance Report, Ministry of Health and Welfare, Japan


AIDS Surveillance Committee, Ministry of Health and Welfare, Japan

Shudo Yamazaki, Chair* -National Institute of Infectious Diseases, Tokyo
Akira Ito -Yokohama City University, Kanagawa
Noriyuki Kawasaki -National Sanatorium Fukui Hospital, Fukui
Takashi Kurimura -Osaka University, Osaka
Masayoshi Negishi -Tokyo Metropolitan Komagome Hospital, Tokyo
Kaoru Shimada -Tokyo Senbai Hospital, Tokyo
Kenji Soda -Yokohama City University, Kanagawa
Kazuo Tajima -Aichi Cancer Center Research Institute, Aichi
Kaneo Yamada -St. Marianna University School of Medicine, Kanagawa

Working Group of Annual AIDS Surveillance, Ministry of Health and Welfare, Japan

Seiichi Ichikawa -Kanagawa Prefectural College of Nursing and Medical Technology, Kanagawa
Mitsuhiro Kamakura -Keio University School of Medicine, Tokyo
Masahiro Kihara -Kanagawa Cancer Center Research Institute, Kanagawa
Yoshikazu Nakamura -Jichi Medical School, Tochigi
Shuuji Hashimoto -University of Tokyo, Tokyo
Akira Yasuoka -International Medical Center of Japan, AIDS Clinical Center, Tokyo

* Corresponding author: Mailing address: National Institute of Infectious Diseases, Toyama 1-21-1, Shinjuku-ku, Tokyo, 162-8640, Japan. E-mail:yamazaki@nih.go.jp, Fax:+81-3-5285-1192


CONTENTS
Introduction
Outline of HIV/AIDS surveillance system
Methods
The surveillance case definition of AIDS in Japan
General notes for surveillance data and its analyses
Results
1. Description of HIV/AIDS cases reported in 1997
2. Analysis of HIV infection and AIDS cases reported through December 31, 1997
3. Secular trends in HIV infection and AIDS cases in Japan
4. Reported number of HIV infection and AIDS cases by bloc and prefecture
Conclusion
Appendix
HIV infection through blood transfusion during window period

Figure 1. HIV infection and AIDS cases by nationality, exposure category,
and year reported.
Figure 2. HIV infection and AIDS cases by nationality and sex.
Figure 3. Presumed place of exposure by year reported for HIV infection
cases of Japanese nationality.
Figure 4. The distribution of HIV infection and AIDS cases by exposure
category, nationality, sex, and region of report.
Figure 5. The distribution of reported numbers per 100,000 population
by prefecture.
Figure 6. Prefectures and regional blocs in Japan
Table‚P. HIV infection and AIDS cases reported in 1996 and 1997 and
cumulative totals by nationality, exposure category, sex, presumed place of exposure, and residential area (bloc).
Table 2. HIV infection and AIDS cases by nationality, sex, and exposure
category, reported 1985 through December 1997.
Table 3. HIV infection and AIDS cases by nationality, sex, and year
reported.
Table 4. HIV infection and AIDS cases by nationality, exposure category,
and year reported.
Table 5. HIV infection and AIDS cases by nationality, sex, exposure
category, and year reported.
Table 6-1. HIV infection cases by nationality, sex, age at diagnosis, and
year reported.
Table 6-2. AIDS cases by nationality, sex, age at diagnosis, and year
reported.
Table 7. HIV infection cases by nationality, sex, presumed place of
exposure, and year reported
Table 8. HIV infection and AIDS cases by nationality, sex, residential area
(bloc), and year reported.
Table 9-1. HIV infection and AIDS cases acquired through heterosexual
contact by age group at diagnosis, presumed place of exposure, residential area (bloc), and year reported for Japanese males.
Table 9-2. HIV infection and AIDS cases acquired through homosexual
contact by age at diagnosis, presumed place of exposure, residential area (bloc), and year reported for Japanese males.
Table 9-3. HIV infection and AIDS cases acquired through heterosexual
contact by age at diagnosis, presumed place of exposure,
residential area (bloc), and year reported for Japanese females.
Table 9-4. HIV infection and AIDS cases acquired through heterosexual
contact by age at diagnosis, presumed place of exposure, residential area (bloc) and year reported for foreign males.
Table 9-5. HIV infection and AIDS cases acquired through homosexual
contact by age at diagnosis, presumed place of exposure, residential area (bloc), and year reported for foreign males.
Table 9-6. HIV infection and AIDS cases acquired through heterosexual
contact by age at diagnosis, presumed place of exposure, residential area (bloc), and year reported for foreign females.
Table 10-1. HIV infection cases by residential area (bloc and prefecture)
and year reported per 100,000 population.
Table 10-2. Japanese HIV infection cases by region and residential area
(bloc and prefecture) and year reported per 100,000 population.
Table 10-3. HIV infection cases of foreign nationality by residential area
(bloc and prefecture) and year reported per 100,000 population.
Table 10-4. AIDS cases by residential area (bloc and prefecture), and year
reported per 100,000 population.
Table 10-5. AIDS cases of Japanese nationality by residential area (bloc
and prefecture) and year reported per 100,000 population.
Table 10-6. AIDS cases of foreign nationality by residential area (bloc and
prefecture) and year reported per 100,000 population.




INTRODUCTION

This is the first English version of the annual HIV infection and AIDS (HIV/AIDS) surveillance report in Japan. This report provides detailed description and analyses of the HIV/AIDS cases compiled in the national HIV/AIDS surveillance database and intends to be a reference document for institutions and individuals interested in the status of the disease in Japan. The main findings of this report are presented as a text, supported by figures with underlying data in a series of tables. The tables are provided with no commentary, except for brief explanatory footnotes.

Unless mentioned otherwise, all data provided in this report are up to the end of 1997.

Outline of HIV/AIDS surveillance system

The surveillance of AIDS in Japan began in 1984 on a voluntary basis and has become mandatory under the so-calledgAIDS Prevention Lawhsince 1989. HIV infection and AIDS are notifiable conditions according to the law.

The law requires all physicians to report HIV/AIDS cases within 7 days of diagnosis to the governor of the prefecture or municipal city in which the patient resides, except for cases in which contaminated blood products are the cause of the infection. Two types of reporting forms are prepared; Form 1 for cases first identified as being HIV positive or AIDS and Form 2 for cases identified as having changed pathological status from asymptomatic carrier to AIDS or from AIDS to death. All reports are collected at the respective local public health departments and are then forwarded to the Diseases Control Division, Ministry of Health and Welfare.

Form 1 contains information regarding age, sex, nationality, clinical status (e.g., asymptomatic, AIDS, or other), date of diagnosis, AIDS-defining illnesses, possible exposure category, presumed place of exposure (in Japan/abroad), and the name and address of the diagnosing doctor. Form 2 contains information regarding the clinical status before the change, age, sex, nationality, the date of diagnosis, and the name and address of the diagnosing doctor. Note that no information such as name, address, date of birth, or occupation of the patients that may help to identify the individuals is included and that Form 2 is therefore only applicable to the cases followed up by physicians.

The AIDS case definition for adult/pediatric cases was revised in 1988 in accordance with the WHO case definition and also in 1994 to expand symptomatic criteria for adult cases to include pulmonary tuberculosis, recurrent bacterial pneumonia, and invasive cervical cancer. The CD4 count is not a part of the AIDS case definition. The AIDS Surveillance Committee reviews each report every 2 months in view of the AIDS case definition criteria. Because of the absence of any case identification, it is not possible to detect duplicates or to make any link between HIV and AIDS.


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