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[Trends in AIDS incidence and mortality in Brazil, 1985 to 1998]
Maria Teresa S S B Alves1, Antônio Augusto M Silva, Maria Ines Battistella Nemes
1Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luis, MA, Brasil. seabra@elo.com.br
Introduction:
AIDS mortality is decreasing in Brazil, especially after the introduction of anti-retroviral therapy. A study was conducted to evaluate AIDS incidence and mortality in a certain area of Brazil.
Methods:
The number of AIDS deaths according to sex in the study period, obtained from registry sources, were used as the numerator of mortality rates. From 1985 to 1995, deaths with underlying cause classified as code 279/1 in the 9th International Classification of Diseases (ICD) and, from 1996 onwards, B20 to B24 codes in the 10th Review were considered AIDS cases. SINAN/MS disease compulsory notification data were used as the numerator of incidence rates. Percentage of variation of the incidence and mortality rates were calculated using a Poisson regression model.
Results:
In the study period, there were 1,211 AIDS cases and 501 deaths. AIDS incidence increased 21.6% during this period (p<0.05) in both sexes, though higher among women. The mortality rates increased exponentially (122.5%) from 1985 to 1991. From 1991 to 1998, mortality remained steady among men but continued to rise among women.
Conclusions:
Stabilization of AIDS mortality in men may be a reflection of large utilization of anti-retroviral therapy. Increasing mortality rate among women could be due to different epidemic dynamics according to sex. This trend is different from the observed in the rest of Brazil, where there has been a fall in AIDS mortality for both sexes since 1991.