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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.
Epidemiological characteristics of a COVID-19 outbreak caused by religious activities in Daegu, Korea
Jong-Yeon Kim, Yu-Mi Lee, Hwajin Lee, Jung-Whan Kim, Shin-Woo Kim
Epidemiol Health. 2021;43:e2021024.   Published online April 14, 2021
DOI: https://doi.org/10.4178/epih.e2021024
  • 13,978 View
  • 359 Download
  • 9 Web of Science
  • 11 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
A coronavirus disease 2019 (COVID-19) outbreak triggered by religious activities occurred in Daegu, Korea in February 2020. This outbreak spread rapidly to the community through high-risk groups. This study describes the characteristics of COVID-19 cases based on S religious group membership and summarizes the Daegu municipal government’s processes and responses to control the outbreak.
METHODS
The epidemiological characteristics of confirmed cases were obtained through basic and in-depth epidemiological surveys. General characteristics, the proportion of asymptomatic cases, the case-fatality rate, and the time-to-event within each group were presented after stratifying confirmed cases according to S religious group membership.
RESULTS
Overall, 7,008 COVID-19 cases were confirmed in Daegu from February 18, 2020 to June 30, 2020, and 61.5% (n= 4,309) were S religious group members. Compared with non-members, members had a higher proportion of female (p< 0.001) and younger age (p< 0.001), as well as lower disease prevalence. At the time of the investigation, 38.4% of cases in members were asymptomatic versus 23.7% of cases in non-members (p< 0.001). The case-fatality rate of non-members aged ≥ 60 years was significantly higher than that of members (p< 0.001). Compared with non-members, members had longer intervals from symptom onset to diagnosis (p< 0.001) and from diagnosis to admission (p< 0.001), and a shorter interval from admission to discharge (p< 0.001).
CONCLUSIONS
The epidemiological features of S religious group members, including the proportion of asymptomatic cases, case-fatality rate, and time-to-event, differed from non-members. The Daegu authorities prevented further COVID-19 spread through immediate isolation and active screening tests of all S religious group members.
Summary
Korean summary
2020년 2월 대구에서는 종교활동에 의한 코로나바이러스감염증-19(COVID-19) 유행이 발생하였다. 2020년 2월 18일부터 6월 30일까지 대구에서 7,008명이 확진되었으며, 이 중 약 61.5%가 S 종교집단의 신도였다. 비신도인 확진자에 비하여 S 종교집단의 신도인 확진자는 높은 여성 비율, 낮은 연령, 낮은 기저질환 유병률, 높은 무증상 감염율, 동일 연령대에 비하여 낮은 치명률을 보였다. 대구시 보건당국은 S 종교집단의 모든 회원에 대한 즉각적인 격리와 적극적인 선별검사를 통해 지역사회 내 더욱 광범위한 COVID-19 확산을 막을 수 있었다.
Key Message
A coronavirus disease 2019 (COVID-19) outbreak triggered by religious activities occurred in Daegu, Korea in February 2020. Overall, 7,008 COVID-19 cases were confirmed in Daegu from February 18, 2020 to June 30, 2020, and approximately 61.5% were S religious group members. Compared with non-members, members had a higher proportion of women, younger age, and lower disease prevalence, higher proportion of asymptomatic cases and lower case-fatality rate within the same age group. The Daegu authorities prevented further COVID-19 spread through immediate isolation and active screening tests of all S religious group members.

Citations

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  • Achieving COVID-19 zero without lockdown, January 2020 to March 2022: The Taiwan model explained
    Yi-Hsuan Chen, Chi-Tai Fang
    Journal of the Formosan Medical Association.2024; 123: S8.     CrossRef
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    Junhyoung Kim, Suyoung Jo, Sung-il Cho
    BMC Infectious Diseases.2024;[Epub]     CrossRef
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    Marn Joon Park, Ji Ho Choi, Jae Hoon Cho
    Journal of Personalized Medicine.2023; 13(3): 402.     CrossRef
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    Jiae Shim, Eunju Lee, Eunyoung Kim, Yeonhwa Choi, Giseok Kang, Bryan Inho Kim
    Osong Public Health and Research Perspectives.2023; 14(2): 110.     CrossRef
  • Factors Related to the Transmission of COVID-19 within Households from Pediatric Initial Cases
    Da Hye Lee, Jong Yeon Kim, Youn Joo Kim, Seung Soo Lee, Won Kee Lee
    Journal of Health Informatics and Statistics.2023; 48(3): 203.     CrossRef
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    Seung Hwan Shin, Eonjoo Park, Sookhyun Kim, Minji Jang, Subin Park, Dong-Hwi Kim, Tae Jong Son, Ji-Hyuk Park
    Osong Public Health and Research Perspectives.2022; 13(2): 162.     CrossRef
  • Preventive Measures Against COVID-19 in Small- and Mid-sized Enterprises from an Early Stage of the Epidemic in Daegu and Gyeongsangbuk-do
    Kiook Baek, Seong-Hui Kim, Chulyong Park, Joon Sakong
    Safety and Health at Work.2022; 13(3): 294.     CrossRef
  • An Experience of the Early Stage of COVID-19 Outbreak in Nursing Homes in Gyeonggi Province, Korea
    Gawon Choi, Na-young Kim, Seon-young Lee, Hae Deun Noh, Heeyoung Lee
    Korean Journal of Clinical Geriatrics.2022; 23(1): 27.     CrossRef
  • Evaluation of a Follow-Up Health Consultation Program for Patients with Coronavirus Disease 2019 in Korea: Using the Context–Input–Process–Product Model
    Keun-Mi Lee, Hae-Jin Ko, Geon Ho Lee, Yun-A Kim, Seung-Pil Jung, A-Sol Kim
    International Journal of Environmental Research and Public Health.2022; 19(13): 7996.     CrossRef
  • Evaluation of the Public Health Emergency Response to the COVID-19 Pandemic in Daegu, Korea During the First Half of 2020
    Hwajin Lee, Keon-Yeop Kim, Jong-Yeon Kim, Sin Kam, Kyeong Soo Lee, Jung Jeung Lee, Nam Soo Hong, Tae-Yoon Hwang
    Journal of Preventive Medicine and Public Health.2022; 55(4): 360.     CrossRef
  • COVID-19 Outbreak in Daegu City, Korea and Response to COVID-19: How Have We Dealt and What Are the Lessons?
    Shin-Woo Kim
    Journal of Korean Medical Science.2022;[Epub]     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
  • 13,807 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
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  • Effect of characteristics on the clinical course at the initiation of treatment for human immunodeficiency virus infection using dimensionality reduction
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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.

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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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  • Smoothed quantile residual life regression analysis with application to the Korea HIV/AIDS cohort study
    Soo Min Kim, Yunsu Choi, Sangwook Kang, Korea HIV/AIDS cohort study
    BMC Medical Research Methodology.2024;[Epub]     CrossRef
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    Infection & Chemotherapy.2023; 55(1): 69.     CrossRef
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    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
    Scientific Reports.2023;[Epub]     CrossRef
  • Attachment Insecurity and Stigma as Predictors of Depression and Anxiety in People Living With HIV
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    Psychiatry Investigation.2023; 20(5): 418.     CrossRef
  • Assessment of Disease Burden and Immunization Rates for Vaccine-Preventable Diseases in People Living with HIV: The Korea HIV/AIDS Cohort Study
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    Infection & Chemotherapy.2023; 55(4): 441.     CrossRef
  • Risk Factors Associated with Medication Adherence in HIV/AIDS Patients
    Kyung Sun Oh, Jin-soo Lee, Euna Han
    Korean Journal of Clinical Pharmacy.2023; 33(4): 254.     CrossRef
  • Effect of single tablet regimen on prescription trends for treatment-naïve patients with HIV/AIDS in Korea
    Kyung Sun Oh, Gi Hyeon Seo, Hee Kyoung Choi, Euna Han
    Scientific Reports.2022;[Epub]     CrossRef
  • Predictors Associated With HIV Status Non-Disclosure in Korea
    Kyungmin Kim, Jungmin Woo
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Comparison of Three Cardiovascular Risk Scores among HIV-Infected Patients in Korea: The Korea HIV/AIDS Cohort Study
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    Infection & Chemotherapy.2022; 54(3): 409.     CrossRef
  • The Incidence and Risk Factors of Renal Insufficiency among Korean HIV infected Patients: The Korea HIV/AIDS Cohort Study
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    Infection & Chemotherapy.2022; 54(3): 534.     CrossRef
  • Estimation of the Number of HIV Infections and Time to Diagnosis in the Korea
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    Journal of Korean Medical Science.2020;[Epub]     CrossRef
  • Human Immunodeficiency Virus-Associated Gastrointestinal Kaposi's Sarcoma: A Case Report
    Hee Joong Lim, So Hyun Park, Seung Joon Choi, Suyoung Park, Hee Young Lee, Jun Won Chung, Dong Hae Chung
    Journal of the Korean Society of Radiology.2020; 81(5): 1260.     CrossRef
  • 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
    Epidemiology and Health.2019; 41: e2019037.     CrossRef
  • Comparison of Characteristics and Survival between Prospective and Retrospective Korea Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Cohort Studies
    Jun Hyoung Kim, Yunsu Choi, Joon Young Song, Shin-Woo Kim, Sang Il Kim, Mee-Kyung Kee, Bo Youl Choi, Jun Yong Choi
    Infection & Chemotherapy.2019; 51(4): 393.     CrossRef

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