Sociodemographic and health profile of TB/HIV co-infection in Brazil: a systematic review

Bastos, Shyrlaine Honda; Taminato, Mônica; Fernandes, Hugo; Figueiredo, Tânia Maria Ribeiro Monteiro de; Nichiata, Lúcia Yasuko Izumi; Hino, Paula

doi:10.1590/0034-7167-2018-0285

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REVIEW • Rev. Bras. Enferm. 72 (5) • Sep-Oct 2019 • https://doi.org/10.1590/0034-7167-2018-0285 copy

Sociodemographic and health profile of TB/HIV co-infection in Brazil: a systematic review

Perfil Sociodemográfico y de salud de la coinfección tuberculosis/VIH en Brasil: revisión sistemática

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to ascertain the epidemiological profile of TB/HIV co-infection in Brazilian scenarios.

Method:

this is a systematic review conducted via electronic search in databases PubMed, EMBASE, LILACS and SciELO, having as inclusion criterion articles based on the Brazilian scenario of TB/HIV co-infection.

Results:

of the total 174 studies, 15 were selected, revealing the epidemiological profile of the co-infection in different scenarios: male, economically active age, low education level, brown/black ethnicity, low income, heterosexual, pulmonary clinical form, alcoholism and Directly Observed Therapy.

Conclusion:

the sociodemographic and epidemiological profile of people with TB/HIV co-infection has an expected occurrence pattern, which corroborates articles found in the literature, either at national level or by grouping the studies according to region or state.

Descriptors:
Tuberculosis; Acquired Immunodeficiency Syndrome; Co-infection; Community Health Nursing; Public Health

Citation	Study scenario	Study design	Sociodemographic profile	Clinical features and outcome	Strobe
Domingos MP, Caiaffa WT, Colosimo EA. Mortalidade, co-infecção por HIV/AIDS e abandono do tratamento como fatores prognósticos para tuberculose em Recife, Pernambuco, Brasil. Cad Saúde Pública 2008; 24(4):887-96⁽⁹9 Domingos MP, Caiaffa WT, Colosimo EA. Mortality, TB/HIV co-infection, and treatment dropout: predictors of tuberculosis prognosis in Recife, Pernambuco State, Brazil. Cad Saúde Pública. 2008;24(4):887-96. doi: 10.1590/S0102-311X2008000400020 https://doi.org/10.1590/S0102-311X200800... ⁾	Recife	Cohort (from January 1, 1996 to December 31, 2000)	Males aged from 40 to 49 years old.	Mixed form, age > 50 years old associated with death.	A
Maruza M, Ximenes RAA, Lacerda HR. Desfecho do tratamento e confirmação laboratorial do diagnóstico de tuberculose em pacientes com HIV/AIDS no Recife, Pernambuco, Brasil. J Bras Pneumol 2008;34(6):394-403⁽¹⁰10 Maruza M, Ximenes RAA, Lacerda HR. Treatment outcome and laboratory confirmation of tuberculosis diagnosis in patients with HIV/AIDS in Recife, Brazil. J Bras Pneumol. 2008;34(6):394-403. doi: 10.1590/S1806-37132008000600010 https://doi.org/10.1590/S1806-3713200800... ⁾	Recife	Cohort (July 2002 to June 2004)	Males with mean age corresponding to 36 years old.	Pulmonary form, cure (56.1%), abandonment of treatment (11.5%), death (29%).	A
Carvalho BM, Monteiro AJ, Pires Neto R da J, Grangeiro TB, Frota CC. Fatores relacionados à coinfecção HIV/tuberculose em um hospital brasileiro de referência. Braz J Infect Dis 2008;12(4):281-6⁽¹¹11 Carvalho BM, Monteiro AJ, Pires-Neto RJ, Grangeiro TB, Frota CC. Factors related to HIV/Tuberculosis coinfection in a brazilian reference hospital. Braz J Infect Dis. 2008;12(4):281-6. doi: 10.1590/S1413-86702008000400005 https://doi.org/10.1590/S1413-8670200800... ⁾	Fortaleza	Case-control (January 2004 to December 2005)	Males aged between 41 and 45 years old with less than 8 years of education.	Alcohol and smoking not related to TB, number of CD4 cells/µl <200.	B
Santos-Neto M, Silva FL, Sousa KR, Yamamura M, Popolin MP, Arcêncio RA. Perfil clínico e epidemiológico e prevalência da coinfecção tuberculose/HIV em uma regional de saúde no Maranhão. J Bras Pneumol 2012;38(6):724-32⁽¹²12 Santos-Neto M, Silva FL, Sousa KR, Yamamura M, Popolin MP, Arcêncio RA. Clinical and epidemiological profile and prevalence of tuberculosis/HIV co-infection in a regional health district in the state of Maranhão, Brazil. J Bras Pneumol. 2012;38(6):724-32. doi: 10.1590/S1806-37132012000600007 https://doi.org/10.1590/S1806-3713201200... ⁾	Maranhão	Cohort (January 2001 to December 2010)	Males aged from 20 to 40 years old, mixed ethnicity, up to 4 years of education, urban residence.	Pulmonary form, DOT (57%), cure (62%).	B
Barbosa IR, Costa ICC. Estudo epidemiológico da coinfecção tuberculose-HIV no nordeste do Brasil. Rev Patol Trop 2014;43(1):27-38⁽¹³13 Barbosa IR, Costa ICC. Estudo epidemiológico da coinfecção tuberculose-HIV no nordeste do Brasil. Rev Patol Trop. 2014;43(1):27-38. doi: 10.5216/rpt.v43i1.29369 https://doi.org/10.5216/rpt.v43i1.29369... ⁾	Northeastern States	Cohort (2002 to 2011)	Males aged from 15 to 39 years old, Pernambuco having shown the highest co-infection rate.	Pulmonary clinical form, cure (39%), 8.9% lethality rate.	B
Santos ML, Ponce MA, Vendramini SH, Villa TC, Santos NS, Wysocki AD, Kuyumijian FG, Gazetta CE. A dimensão epidemiológica da coinfecção TB/HIV. Rev Latino-am Enfermagem 2009; 17(5):683-8⁽¹⁴14 Santos ML, Ponce MA, Vendramini SH, Villa TC, Santos NS, Wysocki AD, et al. The epidemiological dimension of TB/HIV co-infection. Rev Latino-Am Enfermagem 2009];17(5):683-8. doi: 10.1590/S0104-11692009000500014 https://doi.org/10.1590/S0104-1169200900... ⁾	Sao Jose do Rio Preto	Cohort (from January 1998 to December 31, 2006)	Males aged from 20 to 59 years old, most of whom did not finish elementary school.	Pulmonary form, DOT (46%), cure outcome (33%) followed by death (14.3%) and no cases of abandonment of treatment.	B
Vendramini SH, Santos NS, Santos Mde L, Chiaravalloti-Neto F, Ponce MA, Gazetta CE, Villa TCS, Ruffino-Netto A. Análise espacial da co-infecção tuberculose/HIV: relação com níveis socioeconômicos em município do sudeste do Brasil. Rev Soc Bras Med Trop 2010;43(5):536-41⁽¹⁵15 Vendramini SH, Santos NS, Santos ML, Chiaravalloti-Neto F, Ponce MA, Gazetta CE, Villa TC, Ruffino-Netto A. Spatial analysis of tuberculosis/HIV coinfection: its relation with socioeconomic levels in a city in south-eastern Brazil. Rev Soc Bras Med Trop. 2010 [cited 2017 Nov 28];43(5):536-41. doi: 10.1590/S0037-86822010000500013 https://doi.org/10.1590/S0037-8682201000... ⁾	Sao Jose do Rio Preto	Ecological	Up to 3 years of education, income of 2 to 3 minimum wages, association of the rate of co-infection with population from the lower classes.	Data not found.	B
Brunello ME, Chiaravalloti-Neto F, Arcêncio RA, Andrade RL, Magnabosco GT, Villa TC. Áreas de vulnerabilidade para co-infecção HIV-aids/TB em Ribeirão Preto, SP. Rev Saúde Pública 2011;45(3):556-63⁽¹⁶16 Brunello ME, Chiaravalloti-Neto F, Arcêncio RA, Andrade RL, Magnabosco GT, Villa TC. Areas of vulnerability to HIV/TB co-infection in Southeastern Brazil. Rev Saúde Pública. 2011;45(3):556-63. doi: 10.1590/S0034-89102011005000018 https://doi.org/10.1590/S0034-8910201100... ⁾	Ribeirão Preto	Ecological	Males aged from 20 to 39 years old, with 4 to 7 years of education, an intermediate and lower socioeconomic status being associated with higher incidence rates.	Pulmonary clinical form, supervised treatment (48%), cure (48%), abandonment (4.2%), death not related to TB (25%).	B
Hino P, Takahashi RF, Bertolozzi MR, Egry EY. Coinfecção de TB/HIV em um distrito administrativo do Município de São Paulo. Acta Paul Enferm 2012;25(5):755-61⁽¹⁷17 Hino P, Takahashi RF, Bertolozzi MR, Egry EY. Coinfection of Tuberculosis/Human Immunodeficiency Virus in an Administrative District in the City of São Paulo. Acta Paul Enferm. 2012;25(5):755-61. doi: 10.1590/S0103-21002012000500017 https://doi.org/10.1590/S0103-2100201200... ⁾	São Paulo	Cross-sectional	Males aged from 30 to 39 years old, with 4 to 7 years of education.	Pulmonary clinical form, self-administered treatment (48.8%), DOT (34.6%), cure (47.5%) and abandonment of treatment (13%).	B
Rodrigues-Júnior AL, Ruffino-Netto A, de Castilho EA. Distribuição espacial do índice de desenvolvimento humano, da infecção pelo HIV e da comorbidade AIDS-tuberculose: Brasil, 1982-2007. Rev Bras Epidemiol 2014;17(Suppl DSS):204-15⁽¹⁸18 Rodrigues-Júnior AL, Ruffino-Netto A, de Castilho EA. Spatial distribution of the human development index, HIV infection and AIDS-Tuberculosis comorbidity: Brazil, 1982-2007. Rev Bras Epidemiol. 2014 17(Suppl DSS):204-15. doi: 10.1590/1809-4503201400060017 https://doi.org/10.1590/1809-45032014000... ⁾	Brasil	Ecological	Males aged from 20 to 34 years old, heterosexual, the higher rates found in the Southeast and South being associated with the high HDI of these regions up to 1997 and its decline after 1998.	Data not found.	B
Gaspar RS, Nunes N, Nunes M, Rodrigues VP. Análise temporal dos casos notificados de tuberculose e de coinfecção tuberculose HIV na população brasileira no período entre 2002 e 2012. J Bras Pneumol 2016;42(6):416-22⁽¹⁹19 Gaspar RS, Nunes N, Nunes M, Rodrigues VP. Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV coinfection in Brazil between 2002 and 2012. J Bras Pneumol. 2016;42(6):416-22. doi: 10.1590/s1806-37562016000000054 https://doi.org/10.1590/s1806-3756201600... ⁾	Brasil	Cross-sectional	Males, although higher incidence was found in women; reduction in the age group from 0 to 9 years old, and increase in other age ranges, especially for those over 60 years old; increased incidence in the North, Northeast and Midwest regions, decrease in the Southeast region.	Lower chance of cure (50.7%) in relation to individuals with TB only (71.1%), increased rate of abandonment of treatment (13.6%) and greater chance of death (3.6%).	B
Prado TN, Rajan JV, Miranda AE, Dias ED, Cosme LB, Possuelo LG, Sanchez MN, Golub JE, Riley LW, Maciel EL. Clinical and epidemiological characteristics associated with unfavorable tuberculosis treatment outcomes in TB-HIV co-infected patients in Brazil: a hierarchical polytomous analysis. Braz J Infect Dis 2017;21(2):162-70⁽²⁰20 Prado TN, Rajan JV, Miranda AE, Dias ED, Cosme LB, Possuelo LG, et al. Clinical and epidemiological characteristics associated with unfavorable tuberculosis treatment outcomes in TB-HIV co-infected patients in Brazil: a hierarchical polytomous analysis. Braz J Infect Dis. 2017 21(2):162-70. doi: 10.1016/j.bjid.2016.11.006 https://doi.org/10.1016/j.bjid.2016.11.0... ⁾	Brasil	Cross-sectional	Males aged from 20 to 59 years old, with 4 to 7 years of education.	Alcoholism, pulmonary form, higher rate of death among black and mixed-race individuals, and for those over 60 years old.	B
Lima MD, Martins-Melo FR, Heukelbach J, Alencar CH, Boigny RN, Ramos-Júnior AN. Mortalidade relacionada à coinfecção tuberculose e HIV/AIDS no Brasil, 2000-2011: padrões epidemiológicos e tendências temporais. Cad. Saúde Pública 2016;32(10):1-11⁽⁵5 Lima MS, Martins-Melo FR, Heukelbach J, Alencar CH, Boigny RN, Ramos-Júnior AN. Mortality related to tuberculosis-HIV/AIDS co-infection in Brazil, 2000-2011: epidemiological patterns and time trends. Cad Saúde Pública. 2016;32(10):1-11. doi: 10.1590/0102-311X00026715 https://doi.org/10.1590/0102-311X0002671... ⁾	Brasil	Cross-sectional	Single males aged from 30 to 39 years old, black, with 4 to 7 years of education.	Greater mortality of individuals residing in the South and Southeast regions.	A
Magno EDS, Saraceni V, Souza AB, Magno RDS, Saraiva MDGG, Buhrer-Sékula S. Fatores associados à coinfecção tuberculose e HIV: o que apontam os dados de notificação do Amazonas, Brasil, 2001- 2012. Cad. Saúde Pública 2017; 33(5):e00019315⁽²¹21 Magno EDS, Saraceni V, Souza AB, Magno RDS, Saraiva MDGG, Buhrer-Sékula S. Factors associated with TB/HIV coinfection: evidence from notification data in the state of Amazonas, Brazil, 2001-2012. Cad Saúde Pública. 2017;33(5):e00019315. doi: 10.1590/0102-311x00019315 https://doi.org/10.1590/0102-311x0001931... ⁾	Amazonas	Cross-sectional	Mixed race, heterosexual males aged from 25 to 39 years old, residing in the capital.	Pulmonary form. Death (30.9%).	A
Oliveira NF, Gonçalves MJ. Fatores sociais e ambientais associados à hospitalização de pacientes com tuberculose. Rev. Latino-Am. Enfermagem 2013;21(2):507-14⁽²²22 Oliveira NF, Gonçalves MJ. Social and environmental factors associated with the hospitalization of tuberculosis patients. Rev Latino-Am Enfermagem. 2013; 21(2):507-14. doi: 10.1590/S0104-11692013000200006 https://doi.org/10.1590/S0104-1169201300... ⁾	Manaus	Cross-sectional	Males aged from 20 to 29 years old, with 4 to 10 years of education, who did not own a house and lived in a masonry, working with daily garbage collection.	Use of alcohol (50.8%).	B

Scenario	Sex	Age (years)	Education level (years)	Ethnicity	Sexual orientation	Socioeconomic level	Clinical TB manifestation	Alcohol/Tobacco (%)	Type of treatment (%)	Cure (%)	Abandonment (%)	Death (%)
Brasil	Male/fem	20- > 60	4-7	Black	Heterosexual	____	Pulmonary	Alcohol	____	50.7	13.6	3.6
Northeast	Male	15-49	Up to 8	Mixed race	____	____	Pulmonary/Mixed	Non-related	DOT 57	39-62	11.5	8.9-29
Southeast	Male	20-59	3-7	____	____	Low	Pulmonary	____	DOT (34.6 - 48), AT (48.8)	33-48	0-13	14.3-25
North	Male	20-39	4-10	Mixed race	Heterosexual	Low	Pulmonary	Alcohol 50.8	____	____	____	30.9

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[1] Corresponding Author: Shyrlaine Honda Bastos E-mail: shyrlainehonda@gmail.com