Federal Institute of Education, Science and Technology of Ceará, Fortaleza 60040-531, Ceará, Brazil.
Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston 02115, Massachusetts, USA.
Trans R Soc Trop Med Hyg. 2022 Jun 1;116(6):579-588. doi: 10.1093/trstmh/trab183.
Trypanosoma cruzi/HIV coinfection has been described as a relevant clinical event and an emerging public health problem. Here, we describe the epidemiological patterns of deaths related to Chagas disease and HIV/AIDS coinfection in Brazil from 2000 to 2019.
We performed a nationwide population-based study using mortality data obtained from the Brazilian Mortality Information System. We included all deaths recorded in Brazil from 2000 to 2019 in which Chagas disease and HIV/AIDS were mentioned on the same death certificate, either as underlying or as associated causes of death.
Chagas disease and HIV/AIDS were mentioned on 196/22 663 092 death certificates. HIV/AIDS was the underlying cause in 58.2% (114/196) of deaths and Chagas disease in 33.2% (65/196). The average annual mortality rate was 0.05 deaths/1 000 000 inhabitants (95% CI 0.03 to 0.09). The highest death rates were found among males, those aged 60-69 y, Afro-Brazilians, those with 1-3 y of schooling/study and residents in Chagas disease-endemic regions/states. Respiratory, infectious/parasitic and cardiovascular diseases/disorders were the associated causes of death most commonly mentioned.
Mortality due to Chagas disease and HIV/AIDS coinfection may be largely underestimated in Brazil. Our data further reinforce the importance of screening for T. cruzi infection in HIV-infected patients from Chagas disease-endemic areas. Appropriate clinical management should be ensured for Chagas disease and HIV coinfected patients.
克氏锥虫/艾滋病毒合并感染已被描述为一个相关的临床事件和一个新出现的公共卫生问题。在此，我们描述了 2000 年至 2019 年巴西因恰加斯病和艾滋病毒/艾滋病合并感染而死亡的流行病学模式。
我们使用从巴西死亡率信息系统获得的死亡率数据进行了一项全国性的基于人群的研究。我们纳入了巴西在 2000 年至 2019 年期间记录的所有死亡病例，这些死亡病例的死亡证明上同时提到了恰加斯病和艾滋病毒/艾滋病，无论是作为根本原因还是作为死亡的相关原因。
恰加斯病和艾滋病毒/艾滋病在 196/22663092 份死亡证明上被提及。艾滋病毒/艾滋病是 58.2%（114/196）死亡病例的根本原因，而恰加斯病是 33.2%（65/196）。年平均死亡率为 0.05 例/1000000 居民（95%置信区间 0.03-0.09）。死亡率最高的是男性、60-69 岁的人、非裔巴西人、受教育/学习 1-3 年的人和恰加斯病流行地区/州的居民。最常提到的与死亡相关的原因是呼吸道疾病、传染性/寄生虫性疾病和心血管疾病/障碍。
在巴西，因恰加斯病和艾滋病毒合并感染而导致的死亡率可能被大大低估。我们的数据进一步强调了在恰加斯病流行地区对艾滋病毒感染患者进行克氏锥虫感染筛查的重要性。应确保对恰加斯病和艾滋病毒合并感染的患者进行适当的临床管理。
