The Prevalence of High Antiretroviral Coverage and Viral Suppression in Japan: an Excellent Profile for a Downstream Human Immunodeficiency Virus Care Spectrum

Abstract

SUMMARY: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 69.6z and 87.8z 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 87.7z. Thus, our survey revealed that the 2 of the United Nations AIDS Fast-Track targets, 90z treated and 90z virally suppressed, are close to being achieved. However, Japan appears to have fallen short of the upstream target of 90z 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.

Meeting the WHO 90% target: antiretroviral treatment efficacy in Poland is associated with baseline clinical patient characteristics

“…Observed differences in the ratio of virologic success were largely dependent on the baseline patient characteristics and less favourable clinical, immunologic and virologic profile reflected by increased odds ratios of failures associated with the history of AIDS, lower baseline lymphocyte CD4 count, higher HIV viral load at care entry or hepatitis C coinfection and is likely associated with delayed linkage to care. Virologic suppression rates >90% are consistent with the WHO 90–90–90 target and similar to the ones observed for European high income countries such as UK (94% for the threshold of 200 copies/mL) [ 24 ], Sweden (94.7% with viral load <50 copies/mL and 98.5% <200 copies/mL) [ 25 ], Netherlands (94.2–96.6% for the threshold of 100 copies/mL depending on the number of years on treatment) [ 26 ] or ~95% for Switzerland (<200 copies/mL) [ 27 ] and were higher compared to some countries such as Georgia (85%) or Japan (87.7%) [ 28 , 29 ]. Presented virologic outcomes indicate high efficacy of the current, free healthcare and antiretroviral treatment access for all Polish citizens and residents.…”

Universal Health Coverage for Antiretroviral Treatment: A Review

“…This was explained by the fact that France has successfully implemented new HIV/AIDS policies [ 71 ]. In Oman [ 72 ], Afghanistan [ 73 ], Japan [ 74 ], and Mozambique [ 75 ], ART coverage was likewise reported to be higher than the global average point. The high rate of late HIV diagnosis in Oman may be the source of the reasonable rate of ART coverage, because to the accompanying opportunistic diseases, commencing ART is more likely if PLHIV were recently identified.…”

Profiles of 2-Drug Regimen in People Living with HIV-1 in A Real World Setting: A Large-Scale Medical Claim Database Analysis in Japan

“…The reasons for drug switching were not recorded in the MDV database; however, potential reasons include drug-drug interaction, drug resistance or adherence issues. As PLWH in Japan have been noted to have good drug adherence [15], the reasons could be related to negative selection and the unique comorbidities and co-medications of this population.…”