Tuberculosis as primary cause of death among AIDS cases in Rio de Janeiro, Brazil
Abstract: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.
Document Type: Regular Paper
Affiliations: 1: Rio de Janeiro City Health Secretariat, Rio de Janeiro, Rio de Janeiro, Brazil 2: Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA 3: Rio de Janeiro City Health Secretariat, Rio de Janeiro, Rio de Janeiro, Brazil; and Instituto de Pesquisa Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil 4: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA 5: Rio de Janeiro City Health Secretariat, Rio de Janeiro, Rio de Janeiro, Brazil; and Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
Publication date: July 1, 2008
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