Wednesday, December 4, 2013

"Japan in Depth / HIV check system needs improvement"

From The Japan News, 12/2/13:

It has become imperative to improve checks for human immunodeficiency virus, including those on blood donations, following the discovery of the virus in donated blood that was used in transfusions.

About 1,500 people a year develop AIDS or are newly infected with HIV in Japan. As it is possible to prevent the development of HIV into AIDS if the virus is detected early, HIV checks are crucial.

In the latest case, one of two people who received transfusions of the blood in question contracted HIV.

The Red Cross Society told a Health, Labor and Welfare Ministry panel on activities involving blood products that it does not conduct blood donations to check for HIV and does not notify donors of infection, in principle, if found.

The Red Cross Society emphasized this at a meeting of the panel of the ministry’s Pharmaceutical Affairs and Food Sanitation Council held on Tuesday. “There are people who donate blood in the belief that they will be notified if the result is positive,” an official of the society said.

Among about 5 million blood donations per year, 60 to 100 are found to be HIV positive, and are consequently disposed of.

The government recommends people take the tests at public health centers and local governments anonymously and at no charge. However, many checks can only be taken during the day on weekdays.

Ichiro Itoda, director of Shirakaba Clinic in Shinjuku Ward, Tokyo, which provides such tests, as well as treatment for people infected with HIV, said, “Unless people can receive the checks in the evening and on weekends and holidays, and do so at local clinics, the number of blood donations checked for HIV will not decrease.”

The number of HIV checks conducted by public health centers and other conventional sites since 2010 has fallen by about 50,000 to 130,000 a year.

However, the number of people who take HIV tests offered by private institutions by mail has been rapidly increasing.

According to research by a team of Keio University researchers led by Shingo Kato, a junior associate professor of the university, there were 65,000 private-sector HIV checks last year.

For the test, which costs several thousand yen, users take blood samples at home and send them to companies that then conduct the checks. The results can be accessed, for instance, through a password-protected Web portal.

Gunma Medical Examination (GME), a medical institution in Takasaki, Gunma Prefecture, tests more than 10,000 samples a year. An official of the organization said applications for the tests have tripled since Tuesday, when it was revealed that HIV-tainted blood had passed through the checks.

According to GME, three or four samples a year are found to be HIV positive through its tests. Officials said they recommended people found to be HIV positive take a test to confirm the result at a medical institution. GME does not conduct follow-up research analyses.

Prof. Aikichi Iwamoto of the Institute of Medical Science of the University of Tokyo, also chairman of the health ministry’s AIDS Trend Committee, said, “While it’s desirable to increase the options for receiving the checks, infected people need to be linked with medical institutions more smoothly.”

HIV infection through blood transfusions would undermine the very foundation of the blood donation system in this country.

To prevent this, the Japanese Red Cross Society is planning to raise the precision of their HIV tests on donated blood from next summer. However, it is difficult to detect the HIV virus in the blood for about 40 days after infection, as the amount is still small. Strictly speaking, there is no foolproof way to prevent infected blood from slipping in through the test.

Blood donors’ identification is verified through their driver’s license or other such documents. They are also interviewed by a doctor using a questionnaire with 23 questions, such as whether they have been abroad, whether they have donated blood before, and whether they have had sexual relations with multiple partners or other men.

Regarding the case in question, the Japanese Red Cross said the infected donor had lied on the questionnaire. In Australia, donors who make false statements on such questionnaires are penalized. However, the ministry is reluctant to introduce such penalties.

Twenty-five years ago, there were about 8 million blood donations per year in Japan. However, today the number has dwindled to about two-thirds of this figure.

An official of the Japanese Red Cross lamented the situation. “We can’t simply doubt people who come into donate their blood out of good will,” the official said.


Normal life with 1 pill a day (The Japan News, 12/2/13)

AIDS was first recognized in 1981 in the United States and the virus causing the disease was identified in 1983. After that, research on a treatment to prevent the virus from developing into the disease began around the world.

The past decade has seen major advances in therapies, and today’s patients can live longer without developing AIDS if the virus is strictly controlled with multiple medications. A groundbreaking pill combining various effects appeared this year, making it possible for some patients to lead normal lives by just taking one pill a day.

In a follow-up survey of 3,683 Japanese infected with the virus and AIDS patients who began receiving treatment in 2001 or later, the survival rate after eight years of treatment is higher than 95 percent.

A follow-up survey in Europe said there is almost no difference in life expectancy between HIV-infected patients who properly take their drugs and those who are not infected.

While fears of AIDS as a terminal illness may have faded, there are now fewer opportunities to educate the public in AIDS prevention compared to the 1980s and ’90s when scandals over HIV-tainted blood were a major social issue.

Aya Yamamoto, assistant chief of the Health, Labor and Welfare Ministry’s Specific Disease Control Division, said, “Education at schools may overemphasize that AIDS is no longer a fearful disease, which could result in carelessness among students.”

The ministry’s AIDS-related countermeasures, including educational activities and development of treatment systems, cost ¥5.4 billion this fiscal year.

As the figure is dropping by a few hundred million yen each year, the ministry aims to develop new ways to promote AIDS prevention, such as training courses for local government officials and strengthening cooperation with nongovernmental organizations.


The above article is problematic in that people might think they can simply take a pill if they develop HIV and continue to live a healthy life. This is dangerous thinking in that people might get careless and not worry so much about safe sex. Do you really want to have to take a pill for the rest of your life? Do you really want to pay for such a pill for the rest of your life?

Here's a good source of information about the realities of the global situation of HIV/AIDS - "World AIDS Day: AIDS Isn't Over"


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