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Temporal trends in AIDS-associated opportunistic infections in Brazil, 1980-1999

Trends in annual incidence of reported AIDS-associated opportunistic infections (OI/100 adults > 12 years old) among AIDS cases were estimated at the national level in Brazil from 1980 through May 1999. The analysis included chi-square and linear regression modeling. The opportunistic infections included: candidiasis (CD), tuberculosis (TB), Pneumocystis carinii pneumonia (PCP), neurotoxoplasmosis (NT), Kaposi sarcoma (KS), cryptococcal meningitis (CM), and protozoa infections (PI). The overall cumulative incidence rates/100 reported AIDS cases were: CD = 59, TB = 26, PCP = 23, NT = 15, KS = 5, CM = 4, and PI = 4. Annual trends indicated a statistically significant decline in all OIs. However, in the Northeast and Central-West regions there were increases in TB (b = 0.39) and NT (b = 0.20), respectively. TB showed a higher incidence among individuals with less schooling (< 8 years), while PCP and KS had higher incidence rates among those with 8 or more years of schooling, despite similar downward trends. Access to antiretroviral therapy and OI prophylaxis may partially explain these results. However, data reliability, delay in reporting, OI incidence after AIDS, and reporting and diagnostic criteria are factors that also need to be carefully assessed.

Acquired Immunodeficiency Syndrome; Opportunistic Infections; Temporal Trend; Epidemiological Studies


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