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Original Articles
Comparison of HIV characteristics across 3 datasets: the Korea HIV/AIDS Cohort Study prospective, retrospective, and national reporting system
Yunsu Choi, Jun Yong Choi, Bo Youl Choi, Bo Young Park, Shin-Woo Kim, Joon Young Song, Jung Ho Kim, Sang Il Kim
Epidemiol Health. 2024;46:e2024055.   Published online June 18, 2024
DOI: https://doi.org/10.4178/epih.e2024055
  • 1,818 View
  • 89 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The Korea HIV/AIDS Cohort Study has been conducted prospectively for 18 years. However, it faces limitations in representing the entire population of patients with human immunodeficiency virus (HIV) in Korea. To address these limitations and validate the study design, we analyzed characteristics across several HIV datasets.
METHODS
We compared epidemiological and clinical characteristics from 3 datasets: the Korea HIV/AIDS Cohort Study (dataset 1, n=1,562), retrospective cohort data (dataset 2, n=2,665), and the national HIV reporting system of the Korea Disease Control and Prevention Agency (KDCA) (dataset 3, n=17,403).
RESULTS
The demographic characteristics of age, sex, and age at HIV diagnosis did not differ significantly across datasets. However, dataset 3 contained a higher proportion of patients diagnosed after 2008 (69.5%) than the other datasets. Regarding transmission routes, same-sex contact accounted for a greater proportion of dataset 1 (59.8%) compared to datasets 2 (20.9%) and 3 (32.6%). The proportion of patients with CD4 T-cell counts below 200/mm<sup>3</sup> at HIV diagnosis was higher in datasets 1 (39.4%) and 2 (33.3%) compared to dataset 3 (16.3%). Initial HIV viral load measurements were not obtained for dataset 3.
CONCLUSIONS
The Korea HIV/AIDS Cohort Study demonstrated representativeness regarding the demographic characteristics of Korean patients. Of the sources, dataset 1 contained the most data on transmission routes. While the KDCA data encompassed all HIV patients, it lacked detailed clinical information. To improve the representativeness of the Korea HIV/AIDS Cohort Study, we propose expanding and revising the cohort design and enrolling more patients who have been recently diagnosed.
Summary
Korean summary
장기간 운영된 코호트 연구는 다양한 편향으로 인해 모집단의 대표성을 잃을 수 있다. 대표성을 높이기 위해서는 편향을 최소화하고 지속적으로 변화하는 임상 역학적 지침과 특성을 반영할 수 있어야 한다. 지난 18년간 운영된 한국 HIV/AIDS 코호트 연구에서는 코호트 연구 참여 기관에 방문하는 감염인 중 연구 참여자와 비참여자의 특성을 비교하고, 질병관리청 신고자료와의 분포를 비교한 결과, 코호트 연구에 참여하는 것만으로도 대상자 특성에 차이가 있음을 밝혔다. 이에 따라 편향을 최소화하고 대표성을 높일 수 있도록 코호트 연구 설계를 대대적으로 개편하고, 향후 지속될 연구 설계를 제안한다.
Risk of lymphadenopathy from SARS-CoV-2 vaccination in Korea: a self-controlled case series analysis
Mi-Sook Kim, Bongyoung Kim, Jeong Pil Choi, Nam-Kyong Choi, Jung Yeon Heo, Jun Yong Choi, Joongyub Lee, Sang Il Kim
Epidemiol Health. 2023;45:e2023090.   Published online October 13, 2023
DOI: https://doi.org/10.4178/epih.e2023090
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To assess the risk of lymphadenopathy following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination.
METHODS
A self-controlled case series design was used to determine whether the risk of lymphadenopathy was higher in the 1-day to 42-day risk interval after coronavirus disease 2019 (COVID-19) vaccination compared to the control period. In addition, subgroup analyses were conducted according to baseline characteristics, time since vaccination, and sensitivity analyses adjusted for the length of the risk interval.
RESULTS
The risk of developing lymphadenopathy in the risk interval (1-42 days) after COVID-19 vaccination compared to the control period was significantly increased, with a relative incidence (RI) of 1.17 (95% confidence interval [CI], 1.17 to 1.18) when the first, second, and third doses were combined. The RI was greater on the day of vaccination (1.47; 95% CI, 1.44 to 1.50). In subgroup analyses by baseline characteristics, a significantly increased risk or trend toward increased risk was observed in most subgroups except for those aged 70 years and older, with a significant increase in risk in younger individuals, those with a Charlson’s comorbidity index <5, and those who received mRNA vaccines (mRNA-1273>BNT162b2). Within the 1-day to 42-day post-dose risk period, the relative risk was highest during the 1-day to 7-day post-dose period (1.59; 95% CI, 1.57 to 1.60) compared to the control period, and then the risk declined. In the sensitivity analysis, we found that the longer the risk window, the smaller the RI.
CONCLUSIONS
SARS-CoV-2 vaccination is associated with a statistically significant increase in the risk of lymphadenopathy, and this risk was observed only with mRNA vaccines.
Summary
Korean summary
질병관리청의 코로나19 예방접종자료와 국민건강보험공단 자료를 이용하여 수행한 본 자기대조환자군 연구에서 코로나19 백신접종은 42일 내 림프절병증 발생위험을 1.17배 (95% 신뢰구간, 1.17-1.18) 증가시키는 것으로 나타났다. 이러한 위험의 증가는 mRNA 백신에 국한하여 관찰되었으며 연령이 낮을수록, 여성일수록 상대위험도가 높은 것으로 나타났다.
Key Message
This self-controlled case series study, using the Korea Disease Control and Prevention Agency COVID-19 vaccination database and the National Health Insurance Service database, showed an increased risk of developing lymphadenopathy following vaccination (RR 1.17; 95% CI, 1.17 to 1.18). The elevated risk of lymphadenopathy is specifically associated with mRNA platform vaccines, not viral vector vaccines, and is more pronounced in younger individuals and females.
Associations of depression and anxiety with cardiovascular risk among people living with HIV/AIDS in Korea
Kyong Sil Park, Seon Young Hwang, Bo Youl Choi, June Kim, Sang Il Kim, Woo-Joo Kim, Chun Kang
Epidemiol Health. 2021;43:e2021002.   Published online December 24, 2020
DOI: https://doi.org/10.4178/epih.e2021002
  • 15,503 View
  • 397 Download
  • 2 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
As HIV/AIDS is becoming a chronic disease, the risk of developing cardiovascular disease (CVD) among people living with HIV/AIDS is rising. Anxiety and depression, which are common among people living with HIV/AIDS, have been linked with CVD. This study investigated the risk of CVD in people living with HIV/AIDS and explored the effects of depression and anxiety on CVD risk.
METHODS
Data were collected for 457 people enrolled in the Korea Cohort HIV/AIDS study after 2010. Framingham risk scores were calculated to quantify the 10-year risk of developing CVD. Depression and anxiety variables were re-coded as a single combined variable. Multivariable logistic regression analysis was performed, adjusting for age, body mass index, low-density lipoprotein (LDL) cholesterol, triglycerides (TG), duration of human immunodeficiency virus (HIV) positivity after entry into the cohort, and depression/anxiety.
RESULTS
Participants with both depression and anxiety were 2.28 times more likely than those with neither depression nor anxiety to have moderate/high-risk CVD risk. The 10-year risk of developing CVD was affected by LDL cholesterol, TG, age, and duration of HIV infection. LDL cholesterol and TG levels change according to the duration of HIV infection, and metabolic disorders affect the risk of CVD. Thus, a longer duration of HIV infection is associated with a higher risk of developing CVD.
CONCLUSIONS
Screenings for depression and anxiety need to be provided regularly to assess the severity of those symptoms. To help decrease their risk of developing CVD, people living with HIV/AIDS should be offered behavioral modification interventions aimed at developing healthy lifestyle habits.
Summary
Korean summary
본 연구를 통해 우울과 불안이 심혈관질환 발생위험을 증가시키는 영향요인임을 확인하였다. 따라서, HIV 감염자의 우울과 불안에 대한 정기적인 검사 및 상담이 필요하며, 우울 또는 불안한 환자의 심혈관질환의 발병 위험을 줄이기위해 좋은 생활 습관을 위한 행동 수정 및 동기 부여 교육프로그램의 개발이 필요하다.
Key Message
healthcare providers need to provide motivational education for behavioral modifications to decrease patients’ risk of developing CVD, especially among those with depression or anxiety symptoms.

Citations

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  • Depressive Symptoms and Left Ventricular Diastolic Dysfunction Among Men and Women with HIV
    Claudia Martinez, Nel Jason Haw, Violeta J. Rodriguez, Jorge R. Kizer, Wendy S. Post, Katherine C. Wu, Joao A. C. Lima, Jenni M. Wise, Maria L. Alcaide, Michael Plankey, Deborah Konkle-Parker, Sofia Kozlova, Margaret A. Fischl, Adaora A. Adimora, Matthew
    EMJ Cardiology.2024;[Epub]     CrossRef
  • Cardiovascular health (“Life’s Essential 8”), risk of depression and anxiety: a prospective cohort study
    Shuzhen Liu, Xiangju Hu, Meijie Jiang, Ninghao Huang, Hailun Liang, Ruimao Zheng, Shuyan Wang, Jian Qin, Zhiyong Zhang, Tao Huang, Xu Gao
    npj Cardiovascular Health.2024;[Epub]     CrossRef
  • Comorbidities among persons living with HIV (PLWH) in Florida: a network analysis
    Shyfuddin Ahmed, Angel B. Algarin, Hsu Thadar, Zhi Zhou, Tanjila Taskin, Krishna Vaddiparti, Karina Villalba, Yan Wang, Nicole Ennis, Jamie P. Morano, Charurut Somboonwit, Robert L Cook, Gladys E. Ibañez
    AIDS Care.2023; 35(7): 1055.     CrossRef
  • Elevated frequency and everyday functioning implications of vascular depression in persons with HIV disease
    Ilex Beltran-Najera, Andrea Mustafa, Desmond Warren, Zach Salling, Maria Misiura, Steven Paul Woods, Vonetta M. Dotson
    Journal of Psychiatric Research.2023; 160: 78.     CrossRef
  • MENTE X CORAÇÃO: AS DOENÇAS PSIQUICAS E AS CONSENQUÊNCIAS CARDIOVASCULARES: UMA REVISÃO DA LITERATURA
    Beatriz da Silva Araújo, Morgana Gonçalves da Silva
    Revista interdisciplinar em saúde.2021; 8(Único): 292.     CrossRef
Brief Communication
Prospective cohort data quality assurance and quality control strategy and method: Korea HIV/AIDS Cohort Study
Soo Min Kim, Yunsu Choi, Bo Youl Choi, Minjeong Kim, Sang Il Kim, Jun Young Choi, Shin-Woo Kim, Joon Young Song, Youn Jeong Kim, Mee-Kyung Kee, Myeongsu Yoo, Jeong Gyu Lee, Bo Young Park
Epidemiol Health. 2020;42:e2020063.   Published online September 4, 2020
DOI: https://doi.org/10.4178/epih.e2020063
  • 13,806 View
  • 220 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The aim of effective data quality control and management is to minimize the impact of errors on study results by identifying and correcting them. This study presents the results of a data quality control system for the Korea HIV/AIDS Cohort Study that took into account the characteristics of the data.
METHODS
The HIV/AIDS Cohort Study in Korea conducts repeated measurements every 6 months using an electronic survey administered to voluntarily consenting participants and collects data from 21 hospitals. In total, 5,795 sets of data from 1,442 participants were collected from the first investigation in 2006 to 2016. The data refining results of 2015 and 2019 were converted into the data refining rate and compared.
RESULTS
The quality control system involved 3 steps at different points in the process, and each step contributed to data quality management and results. By improving data quality control in the pre-phase and the data collection phase, the estimated error value in 2019 was 1,803, reflecting a 53.9% reduction from 2015. Due to improvements in the stage after data collection, the data refining rate was 92.7% in 2019, a 24.21%p increase from 2015.
CONCLUSIONS
Despite this quality management strategy, errors may still exist at each stage. Logically possible errors for the post-review refining of downloaded data should be actively identified with appropriate consideration of the purpose and epidemiological characteristics of the study data. To improve data quality and reliability, data management strategies should be systematically implemented.
Summary
Korean summary
이 연구는 한국 에이즈 코호트 자료의 연구 목적과 역학적 특성을 고려한 체계적인 질 관리 방법과 결과를 제시한다. 시간적 선후 관계를 고려한 로직을 활용한 자료정제 과정을 비롯한 3단계의 체계적인 질 관리 방법은 이제껏 없었던 국내 코호트 자료 질 관리에 도움이 될 것으로 사료된다.

Citations

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  • Adopting Data to Care to Identify and Address Gaps in Services for Children and Adolescents Living With HIV in Mozambique
    Belmiro Sousa, Sergio Chiale, Hayley Bryant, Lisa Dulli, Tanya Medrano
    Global Health: Science and Practice.2024; 12(2): e2300130.     CrossRef
  • Effect of characteristics on the clinical course at the initiation of treatment for human immunodeficiency virus infection using dimensionality reduction
    Yunsu Choi, Bo Youl Choi, Sang Il Kim, Jungsoon Choi, Jieun Kim, Bo Young Park, Soo Min Kim, Shin-Woo Kim, Jun Yong Choi, Joon Young Song, Youn Jeong Kim, Hyo Youl Kim, Jin-Soo Lee, Jung Ho Kim, Yoon Hee Jun, Myungsun Lee, Jaehyun Seong
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    JMIR Research Protocols.2022; 11(1): e31365.     CrossRef
Original Article
Epidemiological characteristics of HIV infected Korean: Korea HIV/AIDS Cohort Study
Yunsu Choi, Bo Youl Choi, Soo Min Kim, Sang Il Kim, June Kim, Jun Young Choi, Shin-Woo Kim, Joon Young Song, Youn Jeong Kim, Dae Won Park, Hyo Youl Kim, Hee-Jung Choi, Mee-Kyung Kee, Young Hyun Shin, Myeongsu Yoo
Epidemiol Health. 2019;41:e2019037.   Published online September 3, 2019
DOI: https://doi.org/10.4178/epih.e2019037
  • 18,400 View
  • 355 Download
  • 24 Web of Science
  • 20 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To manage evidence-based diseases, it is important to identify the characteristics of patients in each country.
METHODS
The Korea HIV/AIDS Cohort Study seeks to identify the epidemiological characteristics of 1,442 Korean individuals with human immunodeficiency virus (HIV) infection (12% of Korean individuals with HIV infection in 2017) who visited 21 university hospitals nationwide. The descriptive statistics were presented using the Korea HIV/AIDS cohort data (2006-2016).
RESULTS
Men accounted for 93.3% of the total number of respondents, and approximately 55.8% of respondents reported having an acute infection symptom. According to the transmission route, infection caused by sexual contact accounted for 94.4%, of which 60.4% were caused by sexual contact with the same sex or both males and females. Participants repeatedly answered the survey to decrease depression and anxiety scores. Of the total participants, 89.1% received antiretroviral therapy (ART). In the initial ART, 95.3% of patients were treated based on the recommendation. The median CD4 T-cell count at the time of diagnosis was 229.5 and improved to 331 after the initial ART. Of the patients, 16.6% and 9.4% had tuberculosis and syphilis, respectively, and 26.7% had pneumocystis pneumonia. In the medical history, sexually transmitted infectious diseases showed the highest prevalence, followed by endocrine diseases. The main reasons for termination were loss to follow-up (29.9%) and withdrawal of consent (18.7%).
CONCLUSIONS
Early diagnosis and ART should be performed at an appropriate time to prevent the development of new infection.
Summary
Korean summary
국내 감염인은 대부분 성 접촉으로 인해 감염되었고, 감염인의 약 90%가 치료를 경험하였다. 하지만 여전히 결핵, 매독, 주폐포자충 폐렴 등과 같은 HIV 관련 질환의 유병률이 높았고, 치료를 통해 수명이 연장되어 노화 혹은 치료 약제 부작용과 관련된 HIV 비 관련 만성 질환의 유병률도 높았다. 향후 감염인의 HIV/AIDS 비 관련 질환에 대한 연구 및 사망 원인 등에 대한 후속 연구가 필요하겠다.

Citations

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Cohort Profile
Korea HIV/AIDS Cohort Study: study design and baseline characteristics
Bo Youl Choi, Jun Yong Choi, Sang Hoon Han, Sang Il Kim, Mee-Kyung Kee, Min Ja Kim, Shin-Woo Kim, Sung Soon Kim, Yu-Mi Kim, Nam Su Ku, Jin-Soo Lee, Joo-Shil Lee, Yunsu Choi, Kyong Sil Park, Joon Young Song, Jun Hee Woo, Moon Won Kang, June Kim
Epidemiol Health. 2018;40:e2018023.   Published online June 6, 2018
DOI: https://doi.org/10.4178/epih.e2018023
  • 18,967 View
  • 384 Download
  • 16 Web of Science
  • 14 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The number of persons infected by HIV/AIDS has consistently increased in Korea since the first case of HIV/AIDS infection in 1985 and reached 15,208 by 2016. About 1,100 new patients with HIV/ AIDS infections have emerged every year since 2013. In Korea, the Korea HIV/AIDS Cohort Study was established for the evidenced-based prevention, treatment, and effective management of patients infected with human immunodeficiency virus (HIV) in December 2006. This study monitored 1,438 patients, who accounted for about 10% of all patients with HIV/AIDS in Korea, for 10 years with the following aims: (1) to develop an administrative system for the establishment of a HIV/AIDS cohort-based study; (2) to standardize methodologies and the case report forms; and (3) to standardize multi-cohort data and develop a data cleaning method. This study aims to monitor at least 1,000 patients (excluding those for whom investigation had been completed) per year (estimated number of patients who can be monitored by January 2018: 939). By December 2016, the sex distribution was 93.3% for men, and 6.7% for women (gender ratio, 13.9:1.0), and 98.9% of all participants were Korean. More than 50.0% of the participants were confirmed as HIV positive after 2006. This study reports competitive, long-term research that aimed to develop policies for the prevention of chronic infectious diseases for patients with HIV. The data collected over the last decade will be used to develop indices for HIV treatment and health promotion.
Summary
Korean summary
세계적으로 HIV 감염인은 감소하고 있으나, 한국의 HIV 감염은 증가하여 2013년 이후 매년 1,000명이 넘는 신규 감염인이 보고되고 있다. HIV/AIDS 코호트 연구진은 2006년부터 HIV 감염인과 AIDS 환자를 대상으로 6개월 간격의 반복 조사를 시행하여 역학과 임상 자료를 수집하여 데이터베이스를 구축하고, 생물검체를 채취하여 인체자원은행에 보관하여, HIV/AIDS의 발생 기전을 구명하고, 자연사를 파악하며, 예방과 진단, 치료, 관리 방법을 개발하기 위한 기초와 임상, 역학 연구에 활용하고 있다.

Citations

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