The Topic of This Month Vol. 29, No. 6 (No. 340)
1. Trend in HIV/AIDS cases reported during 1985-2007: In 2007, 1,082 new HIV cases (1,007 males and 75 females) and 418 new AIDS patients (377 males and 41 females) were reported, both the largest ever and exceeding the figures in 2006 (952 HIV cases and 406 AIDS patients) (Fig. 1). Japanese males accounted for 86% of all HIV cases (85% in 2005 and 83% in 2006) and for 82% of all AIDS patients (79% in 2005 and 83% in 2006).
During 1985-December 31, 2007, 9,426 HIV cases (7,531 males and 1,895 females) and 4,468 AIDS patients (3,916 males and 552 females) were reported (excluding those infected through coagulation factor products), corresponding to 7.377 HIV cases and 3.497 AIDS patients per 100,000 population, respectively. In addition, 1,438 HIV cases infected through coagulation factor products (including 164 living and 624 deceased AIDS patients) were reported by an independent national survey (as of May 31, 2007).
During 2007, AIDS deaths by case-follow-up reporting to SDCD, MHLW, on the voluntary base, not involving all, totaled 24 (21 Japanese males, 1 Japanese female and 2 non-Japanese cases).
Nationality and gender: Among HIV cases, the number of Japanese males continued to increase (Fig. 2-a), with a significant rise to 931 cases in 2007 (787 in 2006). In contrast, the numbers of Japanese females (4938), non-Japanese females and males (4037 and 7676) did not increase (Fig. 2-a). Among AIDS patients, the number of Japanese males increased to 343 in 2007 (335 in 2006) and that of Japanese females to 22 (20 in 2006) (Fig. 2-b).
Mode of infection and age distribution: Among Japanese males, the record-high of 690 HIV cases (571 in 2006) and 152 AIDS patients (156 in 2006) due to homosexual contact (including bisexual contact) was reported in 2007 (Fig. 3). The number of Japanese male HIV cases infected through homosexual contact significantly increased in the 30s, followed by the 20s, and the 40s also increased (Fig. 4). Among Japanese HIV cases of 15-49 years, the proportion of males due to homosexual contact exceeded 70%, while that of 50 years or older was 38%, being on approximately the same level as that due to heterosexual contact (36%). In Japanese females, HIV cases and AIDS patients were kept in low numbers, most of which were due to heterosexual contract, and HIV cases were most frequently among those aged 25-29 years. Infections due to intravenous drug abuse or mother-to-child infection accounted for less than 1% of all HIV cases and AIDS patients; the figures are lower than those in other countries. In 2007, 6 cases of infection due to intravenous drug abuse (3 HIV cases and 3 AIDS patients) and no case due to mother-to-child infection were reported.
Estimated regions of acquiring infection: In 2007, 88% of HIV cases and 80% of AIDS patients were presumed to have acquired infection in Japan. More non-Japanese male cases were infected in Japan than outside Japan.
Regions of reporting: In each of the following 18 prefectures, physicians diagnosed and reported more than or equal to 10 HIV cases in 2007 (in 16 prefectures in 2006); in the decreasing order Tokyo, Osaka, Aichi, Kanagawa, Chiba, Saitama, Hyogo, Fukuoka, Okinawa, Shizuoka, Hiroshima, Kyoto, Hokkaido, Gifu, Gunma, Tochigi, Ibaraki and Mie. In 2007, HIV cases increased in Kyushu and Chugoku/Shikoku districts as well as Kanto/Koshin-etsu around Tokyo, Kinki and Tokai districts. On the other hand, the increase in AIDS patients in Tokyo and Kanto/Koshin-etsu (excluding Tokyo) district has been restrained after 2000. In contrast, AIDS patients in Hokkaido/Tohoku, Tokai, Kinki, Chugoku/Shikoku and Kyushu districts have been on the increase.
2. HIV-antibody-positive rates among blood donors: In 2007, 102 positive individuals were identified among 4,939,550 blood donations (99 males and 3 females), corresponding to 2.065 positives per 100,000 donations (3.021 for males and 0.180 for females) and the highest ever, exceeding 1.744 in 2006 (Fig. 5). The HIV antibody-positive rate among blood donors divided by HIV infection rate per population, was still very high as compared with that in Western countries (see IASR 21: 140-141, 2000).
3. HIV antibody tests and consultation at health centers: In 2007, 153,816 HIV tests were conducted at health centers and other settings provided by municipalities; this figure further increased largely from 116,550 in 2006 (Fig. 6). The positive results in 2007 counted at 508 (0.33%); of 128,819 tests conducted at health centers, 312 positives (0.24%) were found, while a noticeably higher rate of positives in tests conducted outside of health centers, 196 positives (0.78%) of 24,997 tests, were found. The number of counseling sessions also increased from 173,651 in 2006 to 214,347 in 2007 (Fig. 6). The intensification of HIV testing system to provide more education with consideration for easy accessibility during HIV Testing Promotion Week in June started in 2006 in addition to World AIDS Day in December is closely related to the increase in HIV testing and counseling and keeping high level during other periods (IASR 28: 163-164, 2007).
Conclusion: The reports of HIV/AIDS and HIV antibody positive rates among blood donors in 2007 renewed the past largest number again. Particularly, the increasing rate of HIV cases has accelerated and the spread of HIV infection has not been stopped. In 2007, the increase in male cases due to homosexual contact was conspicuous and by age groups, 20s-30s held a majority as before, and a large increase was also seen in groups of 40s (although it is supposed that they actually infected in their 30s and were tested in their 40s). Against the increase in HIV cases and AIDS patients continuing in major cities in the local districts other than Kanto area around Tokyo, each municipality is proposed to conduct active preventive measures in response to regional situation under cooperation with people engaged in education and medical care, companies and nongovernmental organizations. Because the reports of HIV cases are increasing in parallel with the increase in number of HIV testing, each municipality is also proposed to promote more active education against males with a high risk of HIV infection due to homosexual contact (see p. 147 of this issue) and people among wide age groups around 20s-40s who have never been examined for HIV infection, and to make efforts developing early diagnosis, early treatment and control of spread of HIV infection (see p. 148 of this issue).
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