Coinfecção leishmaniose visceral e Aids no Brasil, 2001 a 2010

Recent changes in the epidemiological profiles of visceral leishmaniasis (VL) and AIDS in Brazil, as the urbanization of VL and the concurrent internalization of HIV infection, have led to an increased number of people coinfected Leishmania/HIV. The coexistence of both diseases makes them more severe, since VL accelerates the onset of AIDS in individuals infected with HIV, leading to cumulative immunosuppression and to stimulation of virus replication. Moreover, in VL endemic areas, AIDS increases a hundred to a thousand times the risk of disease. Whereas mapping and trend analysis are essential tools in the development of a strategy for addressing the coinfection in Brazil, this study aimed to describe the clinical-epidemiological profile of patients with VL coinfected with HIV, compared with the profile of VL patients without coinfection. In this sense, we conducted a descriptive study using secondary data reported to the VL Information System for Communicable Diseases (Sinan) and to the Department of STD, AIDS and Viral Hepatitis of the Ministry of Health. Cases of coinfection VL/AIDS were obtained through the relationship of databases using the probabilistic record linkage approach. We obtained 760 cases of coinfection VL/AIDS prevalent in adult males. The spatial distribution of coinfection cases revealed overlapping areas for both diseases. The profile of coinfected patients VL/AIDS and VL/HIV showed similarities that allowed analyzing them as a single group of coinfected. Comparing the coinfected group to the non-coinfected group, one could observe that weakness, weight loss, cough, associated infection and hemorrhagic phenomena were features more common in coinfected patients, which had a lethality rate of 25%, three times higher than in the non-coinfected group. Also, the relapse proportion was two times greater in coinfected than in non-coinfected group. The results found herein contribute to better knowing the behavior of coinfection VL/AIDS in Brazil, and can help to identify important gaps for improving the healthcare of patients with VL/HIV, avoiding the progression of both diseases.