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Published on: September 5, 2017
Tuberculosis as primary cause of death among AIDS cases in Rio de Janeiro, Brazil
V Saraceni1, B S King, S C Cavalcante
1Rio de Janeiro City Health Secretariat, Rio de Janeiro, Rio de Janeiro, Brazil. valsaraceni@gmail.com
Setting:
Data from the mortality database, Rio de Janeiro City (RJC) Health Department, Rio de Janeiro, Brazil.
Objectives:
To determine the role played by tuberculosis (TB) in Brazil's human immunodeficiency virus (HIV) positive population, we investigated the frequency of TB as the primary cause of death among HIV-positive subjects in RJC.
Design:
Information about acquired immune-deficiency syndrome (AIDS) deaths from 1996 to 2005 in individuals aged >12 years was obtained from the Mortality Information System (SIM), and the cause of death was classified according to the International Classification of Diseases (ICD-10), through primary causes coded in Chapter I--B20 to B24 (HIV disease).
Results:
There were 8601 AIDS-related deaths in RJC between 1996 and 2005. TB was the primary cause of death in 9.0% of all AIDS-related deaths, while Pneumocystis carinii pneumonia (PCP) accounted for 4.7%. TB cases erroneously classified under other infectious diseases may have contributed to an underestimation of the number of TB deaths among HIV-positive patients.
Conclusion:
Our study showed that TB is the leading cause of AIDS-related deaths and is responsible for twice as many deaths as PCP, in a scenario of free access to antiretrovirals. The potential benefits of TB preventive treatment and of the availability of highly active antiretroviral treatment could not be established by this analysis.
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