Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008−2015

Nishijima, Takeshi; Teruya, Katsuji; Shibata, Satoshi; Yanagawa, Yasuaki; Kobayashi, Taiichiro; Mizushima, Daisuke; Aoki, Takeshi; Kinai, Ei; Yazaki, Hirohisa; Tsukada, Kunihisa; Genka, Ikumi; Kikuchi, Yoshimi; Oka, Shinichi; Gatanaga, Hiroyuki

doi:10.1371/journal.pone.0168642

Cited by 22 publications

(19 citation statements)

References 18 publications

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“…These included duration of TDF exposure, history of TDF use, current TDF use, time from the diagnosis of HIV-1 infection, duration of ART, current ART regimen, age, sex, height, body weight, body mass index (BMI; body weight [kg]/height [m] 2 ), history of AIDS (defined as history of or concurrent presence of one of the 23 AIDS-defining diseases including opportunistic infections and malignancies set by the Japanese Ministry of Health, Labour and Welfare) 22 , HIV-1 transmission route, laboratory data (CD4 cell count, HIV viral load, and serum creatinine level, urine dipstick test), and presence or absence of other medical conditions (concurrent nephrotoxic drugs, such as ganciclovir, NSAIDs, and sulfamethoxazole/trimethoprim; diabetes mellitus defined as the use of glucose-lowering agents; hypertension defined as current treatment with antihypertensive agents; dyslipidemia defined as current treatment with lipid-lowering agents; hepatitis B infection defined as positive hepatitis B surface antigen; hepatitis C infection defined as positive HCV antibody; and smoking (if one ever smoked or not). Patients visited our clinic at least every 3 months for measurement of CD4 cell count, HIV-1 viral load, and eGFR, since the prescription period under the Japanese health care system is limited to 3 months 23 . The data of the latest day during the study period when both serum creatinine and CD4 counts were measured were used.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and factors associated with chronic kidney disease and end-stage renal disease in HIV-1-infected Asian patients in Tokyo

Nishijima

Kawasaki

Mutoh

et al. 2017

Sci Rep

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This single-center cross-sectional study determined the prevalence and factors associated with chronic kidney disease (CKD) and end-stage renal disease (ESRD) in HIV-1-infected Asian patients at the largest HIV clinic in Japan. HIV-1-infected patients who visited the clinic between September and December 2016 were analyzed. CKD was defined as estimated glomerular filtration rate of <60 ml/min/1.73 m2 or proteinuria ≥1+, observed at least over three months. A logistic regression model was used to estimate the effects of various variables on CKD. The study included 1,990 patients; with 97% Asians, 34% aged of ≥50 years, and 94% had HIV-1 load <50 copies/ml. The median time from HIV-1 diagnosis to study enrollment and duration of ART were 9.1 years (IQR4.8–14.2) and 7.35 years (IQR3.28–12), respectively. CKD and ESRD were diagnosed in 256 (13%) and 9 (0.5%) patients, respectively. The prevalence of CKD was 18.6% for age 50–59, 28.5% for 60–69, and 47% for over 70. Older age, heavier body weight, diabetes mellitus, hypertension, and longer duration of ART, but not duration of TDF exposure, were associated with CKD. The traditional risk factors, rather than HIV-1-related variables, were associated with CKD, suggesting the importance of management of such comorbidities in maintenance of renal function.

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Section: Methodsmentioning

confidence: 99%

Prevalence and factors associated with chronic kidney disease and end-stage renal disease in HIV-1-infected Asian patients in Tokyo

Nishijima

Kawasaki

Mutoh

et al. 2017

Sci Rep

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“…In the present survey, the coursework did not address HIV and sexually transmitted diseases (STDs) among men who have sex with men (MSM), and yet these diseases have been very serious public health concerns in Japan. For example, a recent resurgence in reported syphilis cases was recognized among HIV-1-infected MSM in Japan [39]. Also, incident Hepatitis C (HCV) infection is increasing among HIV-1-infected MSM non-injection drug users in Japan [40].…”

Section: Current Status and Issues Facing Sgm Education In Japanmentioning

confidence: 99%

Prevalence and curriculum of sexual and gender minority education in Japanese medical school and future direction

Yamazaki

Aoki

Otaki

2020

Medical Education Online

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Background: In Japan, sexual and gender minorities (SGM) remain stigmatized, provoking hospital access barriers and health disparities from judgmental care. Japan's Westerninfluenced introduction of SGM course content into medical education for future physicians addresses these disparities, although often perfunctorily and inconsistently. Objective: To examine the prevalence and characteristics of medical education curriculum with respect to SGM patients, we surveyed medical schools. Methods: A medical education faculty member from each of 80 Japanese medical schools received double postcards to identify relevant SGM coursework. Upon acknowledgement, 43 schools received seven-item anonymous questionnaires in March 2018. Survey results were analyzed from the perspective of three of the qualities and abilities required of a physician -Patient Care, Knowledge for Practice, and Professionalism from Japan's Medical Core Curriculumto develop recommendations for outcomes-based SGM curriculum through the lens of Van Melle's medical education framework. Results: The response rate was 46%, with 22 schools providing SGM lectures mostly to firstand third-year students. Obstetrics and Gynecology, Neuropsychiatry, and Introduction to Medicine lectures were the top three subjects offering SGM lectures, primarily consisting of basic knowledge of SGM and Differences in Sex Development. Several lectures addressed the health challenges of SGM. Primary reasons for not offering SGM lectures were lack of suitable instructors or no school policies. Conclusions: Students can best experience the humanity of SGM patients and employ more appropriate diagnostic practices and modes of treatment with targeted curriculum to address SGM health disparities and inclusion of SGM patients in clinical practice training. To disseminate SGM education in Japanese medical schools, development of qualified instructors and policies is essential, employing currently active experts. The Van Melle reforms framework can guide in the development of recommended tailored learning experiences and lectures for improved and expanded SGM education, integrating appropriate coursework within current medical core curriculum structure. ARTICLE HISTORY

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“…[14][15][16] While these and other practices have been suggested as possible contributors to the recent rise of syphilis notifications in Japan, very few studies have evaluated potential predictors for syphilis acquisition in Japan. Recently, there was a cohort study analysing the risk factors of incident syphilis infection among HIVpositive MSM in Japan, 17 but behavioural factors were not assessed. To better understand the syphilis outbreak Case-control study of risk factors for incident syphilis infection among men who have sex with men in Tokyo, Japan positive for T. pallidum DNA (polA/TpN47 genes) by polymerase chain reaction (PCR) 20, 21 at the enrolment visit (PCR method available on a limited basis for research).…”

mentioning

confidence: 99%

Case-control study of risk factors for incident syphilis infection among men who have sex with men in Tokyo, Japan

Ishikane

Arima

Itoda³

et al. 2019

WPSAR

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Introduction: In Japan, syphilis notifications have increased. Men who have sex with men (MSM) in Tokyo have contributed substantially to the increase in syphilis notifications. We thus aimed to determine the correlates of incident syphilis among them. Methods: MSM who attended a Tokyo clinic that serves sexual minorities were recruited in a case-control study in 2015. A case was seropositive for primary/secondary/asymptomatic syphilis at enrolment visit and seronegative at prior visit or had oral ulcers positive for Treponema pallidum DNA at enrolment. For each case, two controls seronegative at enrolment and prior visit were selected. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated to assess for correlates of case status. Results: Among 35 cases, the median age was 37 (range = 21–63) years and was similar to the 71 controls. Among HIV-positive participants (26 cases and 67 controls), cases were independently associated with higher frequency of anal or oral sex (OR = 3.4; 95% CI = 1.4–8.6; increase per category from < 1/month, ≥ 1/month but < 1/week, to ≥ 1/week) and no or inconsistent condom use during anal or oral sex (OR = 3.0; 95% CI = 1.1–8.3; increase per category from using every time, occasionally, to never), adjusted for residency and time between visits. Discussion: Modifiable behaviours were associated with incident syphilis, and dissemination of prevention messages are needed.

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Incidence and Risk Factors for Incident Syphilis among HIV-1-Infected Men Who Have Sex with Men in a Large Urban HIV Clinic in Tokyo, 2008−2015

Cited by 22 publications

References 18 publications

Prevalence and factors associated with chronic kidney disease and end-stage renal disease in HIV-1-infected Asian patients in Tokyo

Prevalence and factors associated with chronic kidney disease and end-stage renal disease in HIV-1-infected Asian patients in Tokyo

Prevalence and curriculum of sexual and gender minority education in Japanese medical school and future direction

Case-control study of risk factors for incident syphilis infection among men who have sex with men in Tokyo, Japan

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