Martins-Melo Francisco Rogerlândio, Lima Mauricélia da Silveira, Alencar Carlos Henrique, Ramos Alberto Novaes, Heukelbach Jorg
Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil.
Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil Anton Breinl Centre for Public Health and Tropical Medicine, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia
Trans R Soc Trop Med Hyg. 2014 Jun;108(6):338-47. doi: 10.1093/trstmh/tru050. Epub 2014 Apr 4.
Visceral leishmaniasis (VL)-HIV/AIDS co-infection is an emerging health problem with high case fatality. This study presents the epidemiological and clinical aspects of deaths related to VL-HIV/AIDS co-infection in Brazil.
This was a nationwide population-based study based on mortality data obtained from the Brazilian Mortality Information System. We included all deaths between 2000 and 2011 (about 12.5 million), and analyzed those in which VL and HIV/AIDS were mentioned in the same death certificate.
VL and HIV/AIDS were mentioned in 272 deaths. HIV/AIDS was the underlying cause in 59.6% (162/272) of deaths by VL-HIV/AIDS co-infection, and VL the underlying cause in 39.3% (107/272). Predominating characteristics were: male gender (79.0%, 215/272), age 30-39 years (41.0%, 111/271), brown race/color (61.6%, 159/258) and residence in the Northeast region (47.4%, 129/272). Average annual age-adjusted mortality rate was 0.13 deaths/1 000 000 inhabitants. Deaths were distributed in 20 of 27 Brazilian states. There was an increasing trend of mortality (annual percent change: 16.4%). Infectious/parasitic (58.8%) and respiratory (51.1%) diseases/disorders, particularly sepsis, respiratory failure and pneumonia, were most commonly associated with deaths related to this co-infection.
VL-HIV/AIDS co-infection is an increasing public health problem in Brazil. The systematic description of the epidemiological characteristics and magnitude of mortality related to VL-HIV/AIDS co-infection reflects the need to intensify control measures and disease surveillance.
内脏利什曼病（VL）与艾滋病毒/艾滋病合并感染是一个新出现的、病死率很高的健康问题。本研究介绍了巴西与VL-艾滋病毒/艾滋病合并感染相关死亡的流行病学和临床情况。
这是一项基于全国人口的研究，数据来源于巴西死亡信息系统的死亡率数据。我们纳入了2000年至2011年期间的所有死亡病例（约1250万例），并分析了在同一份死亡证明中提及VL和艾滋病毒/艾滋病的病例。
272例死亡病例中提及了VL和艾滋病毒/艾滋病。在VL-艾滋病毒/艾滋病合并感染导致的死亡病例中，59.6%（162/272）的根本死因是艾滋病毒/艾滋病，39.3%（107/272）的根本死因是VL。主要特征为：男性（79.0%，215/272）、年龄30-39岁（41.0%，111/271）、棕色人种（61.6%，159/258）以及居住在东北地区（47.4%，129/272）。年龄调整后的年均死亡率为每100万居民中有0.13例死亡。死亡病例分布在巴西27个州中的20个。死亡率呈上升趋势（年度百分比变化：16.4%）。感染性/寄生虫性疾病（58.8%）和呼吸道疾病（5
