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동아시아에서의 HIV/AIDS 역학

Epidemiology of HIV/AIDS in East Asia

김명수|최준용|김영근|박윤선|김준명|김연아|송영구|신소연|Shuzo Matsushita|Taisheng Li|Hsi-Hsun Lin|Patrick Li
대한감염학회 (The Korean Society Of Infectious Diseases)|2007.02|Infection and Chemotherapy|제49권 제1호|pp. 24-37

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초록

목 적 : 최근 동아시아에서의 HIV 감염자 수의 급속한 증가는 여러 가지 심각한 문제를 야기하고 있다. 따라서 이 지역에서의 HIV/AIDS 역학에 대해서 정확한 조명 및 분석이 무엇보다 필요하다. 이에 저자들은 동아시아 HIV 네트워크(East Asia Network on HIV; EAN-HIV)를 통하여 동아시아 HIV/AIDS 유행의 시작, 변천 및 현황에 관하여 알아보고자 한다. 재료 및 방법 : 동아시아에 HIV/AIDS가 처음 유입된 1984년부터 2005년까지 한국, 일본, 중국, 대만, 홍콩의 HIV/AIDS 관련 역학 자료를 동아시아 HIV 네트워크(East Asia Network on HIV; EAN-HIV)를 통하여 수집하고 분석하였다. 결 과 : 동아시아에서의 HIV/AIDS 유행은 1980년대 중반에 시작되었다. 2005년 말까지 한국에서는 3,829명, 일본에서는 7,078명(혈우병 환자 제외), 대만에서는 10,423명, 홍콩에서는 2,825명의 HIV 감염자가 보고되었으며, 중국에서는 141,241명이 보고되었으나 실제로는 84만명 이상의 감염자가 존재할 것으로 추정하고 있다. 주사마약사용, 혈장매매, 성접촉에 의한 감염이 주를 이루고 있으며, 감염자 중 남자가 많고 20-30대가 다수를 차지하였다. 중국이나 대만의 경우에는 최근 감염자 수가 급증하고 있으며 주사마약사용에 의한 감염이 주로 문제가 되고 있는 반면, 한국, 일본, 홍콩의 경우에는 남성동성애자에 의한 전파가 주가 되고 있다. 동아시아에서 유행하는 HIV의 주 아형은 B, C, CRF01_AE 형이며, 최근에는 CRF07_BC형이 확산되고 있다. 결 론 : 동아시아의 HIV 감염률은 빠르게 증가하며, 또한 HIV/AIDS 역학도 빠르게 변화하고 있다. 이 지역의 유행은 중국이 부분적으로 커다란 영향을 미치고 있다.

Abstract

Background : Recent predictions of catastrophic epidemic surge of HIV infection in East Asia concern experts and governmental organizations. As in many other areas, countries in East Asia show diversities in their HIV epidemics, both geographically and temporally. However, they have similar regional, cultural and racial characteristics which allow them to have certain common factors. Having a clear picture of the current extent and feature of HIV/AIDS in this region is a very difficult task largely due to the fast pacing of expending epidemic and difficulty in data-sharing among countries in the region. Hence, we decided to study the epidemiologic feature of HIV/AIDS in East Asia through East Asia Network on HIV (EAN-HIV). Materials and Methods : The epidemiological patterns of HIV/AIDS in East Asian countries were investigated by collecting data through EAN-HIV. Results : The HIV/AIDS epidemic in East Asia started relatively late at mid 1980s. Since then, the number of newly infected HIV/AIDS cases has been steadily increasing with stiffer escalation in recent years. In China and Taiwan, IDU plays an important part in the swiftly growing HIV epidemics; however, in other regions like Korea, Japan, and Hong Kong, MSM (men who have sex with men) seems to be more of a problem. The major subtypes of HIV in East Asia are subtype B, C, and CRF01_AE, and rapidly evolving circulating recombinant forms (CRF) between subtypes such as CRF07_BC give dynamic change to the current status. Conclusion : The incidence of HIV/AIDS is rapidly increasing in East Asia. The epidemic pattern has undergone dynamic changes over time. China seems to be the leading source of HIV/AIDS epidemic in East Asia due to its large population and rapidly growing epidemics.

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