Some hospitals loaded with AIDS, HIV cases

Hospitals around Japan treating AIDS and HIV infection have widely varying case loads, with some overflowing with patients and others having not treated any, a government research team said Saturday.

Many of the hospitals in urban areas are reaching their limit. Some are treating more than 400 people as ever-increasing patients are concentrated at medical institutions that offer advanced medical care.

On the other hand, more than 10 percent of the hospitals have never treated a person with AIDS or HIV, and a third of the medical institutions did not have any new cases in the past two years, the Health, Labor and Welfare Ministry team said.

At hospitals with many such patients, more than 70 percent of AIDS specialists said they expect to reach the limit of their capacity within two years at the current rate of increase.

Considering that many such institutions are on the brink of being snowed under, the team members pointed out the need for more hospitals offering AIDS and HIV treatment and for coordination and burden-sharing among the hospitals.

To alleviate the imbalance, the team recommended setting up a system in which people whose conditions have stabilized after initial treatment at experienced hospitals can be referred to less crowded ones.

The AIDS Clinical Center at the International Medical Center of Japan in Tokyo will start dispatching experts to hospitals in the greater Tokyo area this fiscal year to review their AIDS care system.

The team’s are based on a survey of 364 hospitals that provide treatment for AIDS and HIV. So far, 256, or 70 percent, have responded to the survey sent December.

The team is led by the Satoshi Kimura, head of the AIDS Clinical Center.

According to the survey, 13 percent of hospitals that responded had never treated people with AIDS or HIV.

Between April and October 2003, 26 percent of the hospitals had no people with AIDS or HIV, while only 3 percent said they had more than 100 such patients.

Eighteen percent said they had no doctors specializing in HIV treatment, while 25 percent said they had only one such specialist. Nearly half of the medical facilities said they are not capable of quickly diagnosing pneumocystis carinii pneumonia, which people with AIDS sometimes develop.

One-third said they have made advances since the previous survey in 1997 in terms of accepting both inpatients and outpatients.

Of 20 specialists at three Tokyo hospitals that were treating more than 400 people each, 15 said they can accept new patients at the current rate for less than two years. Five said they expect to reach their limit in six to 12 months.

In response to questions about the time involving medical consultations and care, the 20 doctors said they think an average of 43.8 minutes is required for an initial visit and 19.5 minutes for each subsequent visit per patient.

But in reality, they are able to spend only 27.8 minutes on average for the initial visit and 13.9 minutes for following ones, the survey shows.

Kimura said there are an estimated 20,000 to 30,000 people in Japan who do not realize they are infected with HIV.