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PDF File - 日本エイズ学会
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Present State of HIV Antibody Survey Subjects and HIV/AIDS Patient
Management at Kawasaki Medical School Hospital
Hirotoshi TOKUNAGA+, Hideho WADA+, Osamu YAMADA, and Takashi SUGIHARA+
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Division of Hematology, Department of Medicine, Kawasaki Medical School, Kurashiki, Japan
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Graduate School of Medicine, Yamaguchi University, Ube, Japan
Objective : To characterize the state of management of HIV/AIDS patients at Kawasaki
Medical School Hospital, which is a local core hospital for AIDS treatment in Okayama
Prefecture.
Methods : The subjects of an HIV antibody survey and ,+ HIV/AIDS patients treated at
our hospital between January ,**+ and December ,**/ were investigated.
Results : The patients consisted of ,* men and one woman with a mean age of -,.1 years
at initial presentation. There were ++ HIV-infected persons with a mean age of -*.3 years.
Ten of these patients developed AIDS, and they had a slightly higher mean age of -..1 years
at initial presentation. The mean CD.-positive cell count of the ,+ patients was +3,/ml at
diagnosis. The six patients who were diagnosed with AIDS in our hospital had a mean CD.positive cell count of only -./ml. All ,+ patients were infected with HIV through routes other
than blood products, including +- patients infected through homosexual intercourse, three
through heterosexual intercourse, and five via unknown routes. Eleven patients were referred
from other prefectures, including five from Osaka and four from Tokyo. The number of the
subjects of an HIV antibody survey increased in five years, but there were no positive patients.
Discussion : The main characteristic of HIV patients at this local core model hospital was
that only a few of them were infected in Okayama Prefecture. Many of them were referred
from larger cities outside the prefecture after they were transferred by their companies or
returned home. However, it is expected that the number of patients infected within Okayama
Prefecture will increase in the future. There is also an increasing trend for patients to develop
AIDS before initial presentation. Therefore, it is important to increase the performance of
HIV antibody testing.
Key words : local core model hospital for AIDS treatment, HIV antibody survey, AIDS
patients, Okayama Prefecture
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