Shift of HIV/AIDS Deaths to an Older Age and Gender Difference: Inferences Derived from the Vital Statistics of Japan

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From 1995 to 2000, the mortality rates of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients < 54 years of age have declined; however, since 2000, deaths of HIV/AIDS patients aged > 55 have started to increase. Although deaths directly linked to infections have declined since 2005, those related to malignancy, encephalopathy, interstitial pneumonia, wasting syndrome, etc. persisted. In 10 years from 1999–2004 to 2010–2017, the age at death shifted by 5 years towards an older age in the general population and in patients with HIV/AIDS (mainly males), adult T-cell leukemia, or Creutzfeldt-Jakob disease. Among these, HIV/AIDS patients and the general population exhibited an unequivocal gender difference. As of 2011–2016, the median of the deaths of the HIV/AIDS patients was 52.5 years for males and 70 years for females, while the median of the deaths of the general population was 75 years for males and 85 years for females. Hence, male HIV/AIDS patients died 22.5 years earlier and female HIV/AIDS patients 15 years earlier than did the general population. A common denominator of HIV/AIDS-related deaths and deaths among the general population could be CD4⁺T cells as these cells are primary targets of HIV, and a decline in naïve CD4⁺T cell count is a hallmark of aging.