Department of Community Health, School of Medicine, Federal University of Ceará, 60430-140 Fortaleza, CE, Brazil.
J Trop Med. 2012;2012:534649. doi: 10.1155/2012/534649. Epub 2012 Aug 28.
Chagas disease in patients with HIV infection represents a potentially serious event with high case fatality rates. This study describes epidemiological and clinical aspects of deaths related to Chagas disease and HIV/AIDS coinfection in Brazil, 1999-2007. We performed a descriptive study based on mortality data from the nationwide Mortality Information System. Of a total of about 9 million deaths, Chagas disease and HIV/AIDS were mentioned in the same death certificate in 74 cases. AIDS was an underlying cause in 77.0% (57) and Chagas disease in 17.6% (13). Males (51.4%), white skin color (50%), age group 40-49 years (29.7%), and residents in the Southeast region (75.7%) were most common. Mean age at death was significantly lower in the coinfected (47.1 years [SD ± 14.6]), as compared to Chagas disease deaths (64.1 years [SD ± 14.7], P < 0.001). Considering the lack of data on morbidity related to Chagas disease and AIDS coinfection, the use of mortality data may be an appropriate sentinel approach to monitor the occurrence of this association. Due to the epidemiological transition in Brazil, chronic Chagas disease and HIV/AIDS coinfection will be further complicated and require the development of evidence-based preventive control measures.
在感染 HIV 的患者中，恰加斯病是一种具有高病死率的严重疾病。本研究描述了 1999-2007 年巴西恰加斯病与 HIV/AIDS 合并感染患者的流行病学和临床特征。我们基于全国性死亡信息系统中的死亡数据进行了描述性研究。在总计约 900 万例死亡中，有 74 例在同一份死亡证明中同时提到了恰加斯病和 HIV/AIDS。艾滋病是主要死因（77.0%，57 例），恰加斯病是次要死因（17.6%，13 例）。男性（51.4%）、白人（50%）、40-49 岁年龄组（29.7%）和东南部地区（75.7%）的患者居多。合并感染患者的死亡年龄（47.1 岁[SD ± 14.6]）明显低于仅患恰加斯病患者（64.1 岁[SD ± 14.7]，P < 0.001）。考虑到恰加斯病和 HIV/AIDS 合并感染相关发病率数据的缺乏，利用死亡率数据可能是监测这种关联性发生的一种适宜的哨点方法。由于巴西的流行病学转变，慢性恰加斯病和 HIV/AIDS 合并感染将变得更加复杂，需要制定基于证据的预防控制措施。
