Visceral leishmaniasis and HIV/AIDS in Brazil: Are we aware enough?

• Published in: PLoS neglected tropical diseases 2017-09, Vol.11 (9), p.e0005772-e0005772
• Main Authors: Leite de Sousa-Gomes, Marcia, Romero, Gustavo Adolfo Sierra, Werneck, Guilherme Loureiro
• Format: Article
• Language: English
• Subjects: Access to information; Acquired immune deficiency syndrome; Adult; AIDS; Biology and Life Sciences; Brazil - epidemiology; Care and treatment; Coinfection - epidemiology; Coinfection - parasitology; Coinfection - virology; Comorbidity; Cough; Detection; Development and progression; Epidemiology; Fatalities; Forecasts and trends; Funding; HIV; HIV infections; HIV Infections - complications; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Infections; Leishmania; Leishmaniasis, Visceral - complications; Leishmaniasis, Visceral - epidemiology; Males; Medicine and Health Sciences; Middle Aged; Mortality; Parasitic diseases; Patients; People and places; Population Surveillance; Public health; Rural areas; Tropical diseases; Urbanization; Vector-borne diseases; Visceral leishmaniasis; Young Adult
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0005772

The urbanization of visceral leishmaniasis (VL) and the concurrent movement of the HIV infection to rural areas in Brazil are possible mechanisms associated with an increased number of Leishmania/HIV coinfected people. This study aimed to describe the clinical and epidemiological profile of VL/HIV coinfected patients and compare this profile to non-coinfected VL patients. Cases of VL/HIV coinfection were obtained through a probabilistic record linkage of databases of VL and AIDS cases from the Brazilian Ministry of Health. We retrieved 760 cases of VL/HIV coinfection, most prevalent in adult males, with incidence ranging from 0.01 to 0.07 cases, per 100.000 population, in 2001 and 2010, respectively. Case-fatality rates were 27.3% in 2001 and 23.2% in 2010. Weakness, weight loss, cough, other associated infections and haemorrhagic phenomena were more commonly found among coinfected patients, which had a fatality rate three times higher as compared to the non-coinfected group. The relapse proportion was two times greater among coinfected (6.3%) than non-coinfected (3.1%). The results found herein contribute to the increase of knowledge of the epidemiological situation of VL/HIV coinfection in Brazil and reinforce the necessity of implementing specific strategies to improve early case detection and efficacious and less toxic treatment in order to achieve lower case-fatality rates.