Deaths related to Chagas disease and HIV/AIDS coinfection in Brazil: a nationwide population-based analysis

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.

Epidemiological-clinical profile and mortality in patients coinfected with Trypanosoma cruzi/HIV: experience from a Brazilian reference center

“…Similar to other infectious diseases, T. cruzi can act an opportunistic microorganism in immunosuppressed individuals. Although the first case of T. cruzi/HIV coinfection was reported in the 1980s 19 , its frequency and eventual CD reactivation rates, as well as the clinical and laboratory profile of coinfected patients, their survival times and mortality rates are still underreported 20,21 . Our study aimed to describe the prevalence of T. cruzi/HIV coinfection in a cohort of patients regularly followed up at a Brazilian referral center for infectious diseases, as well as their epidemiological and clinical characteristics, the incidence of CD reactivation, mortality rate, and main causes of death.…”