ArticlePloS one2018
Tuberculosis burden on AIDS in Brazil: A study using linked databases.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Record linkage in tuberculosis epidemiological surveillance in Brazil: systematic methodological literature review.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2026Pooled it
- HIV and Tuberculosis Coinfection in Brazil: Cohort Profile Monitored by the Unified Health System (2015-2018).Journal of community health · 2026Observational
- Time from treatment initiation to HIV viral suppression in public care facilities in Brazil: A nationwide linked databases cohort.PloS one · 2024Article
- Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem.BMC infectious diseases · 2022Observational
- Mortality and survival of tuberculosis coinfected patients living with AIDS in São Paulo, Brazil: a 12-year cohort study.BMC infectious diseases · 2022Article
- Novel stepwise approach to assess representativeness of a large multicenter observational cohort of tuberculosis patients: The example of RePORT Brazil.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2021Observational
- The burden of tuberculosis and attributable risk factors in Brazil, 1990-2017: results from the Global Burden of Disease Study 2017.Population health metrics · 2020Article
- Factors associated with death in patients with tuberculosis in Brazil: Competing risks analysis.PloS one · 2020Article
- Administrative Data Linkage in Brazil: Potentials for Health Technology Assessment.Frontiers in pharmacology · 2019Review
- Prevalence of coinfections in women living with human immunodeficiency virus in Northeast Brazil.Revista da Sociedade Brasileira de Medicina Tropical · 2019Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo estimate the burden of tuberculosis (TB) in reported AIDS cases, to compare the characteristics of TB/HIV subjects with those without TB and to evaluate survival with or without TB in Brazil.
methodsThe data source was the linked database between AIDS (2011-2014) and TB (2011-2014) databases from the Notifiable Diseases Information System (SINAN). The sociodemographic, clinical, laboratory results and use of antiretroviral therapy (ART) data were compared by TB occurrence or not. Survival probability was estimated using the Kaplan-Meier method and associated factors were sought using Cox regression.
resultsThe proportion of TB diagnosed from 2011 to 2014 among AIDS cases reported between 2006 and 2014 was 6.3%. Subjects coinfected with TB were predominantly male, older, with lower schooling, with lower CD4 count, higher viral load, and higher proportion of ART initiation than those without TB. 57.5% were diagnosed with HIV before TB, 38.2% as concurrent TB/HIV and 4.3% with TB before HIV. 16,466 reported TB cases were not found in the AIDS database, although registered as HIV-infected in the SINAN TB database between 2011 and 2014. Median survival for PLHIV was 581 days, with 582 for those without TB, significantly higher than 547 for those with TB (log-rank teste, p = 0,001). In the Cox multivariate analysis, male gender [aHR = 1.27 (CI 95% 1.22-1.33)], older age [aHR = 1.020 (CI 95% 1.019-1.022)] and TB coinfection [aHR = 1.97 (CI 95% 1.88-2.07)] were positively associated with adjusted hazard of death, whereas CD4 count 200-499 cells [aHR = 0.21 (CI 95% 0.20-0.22)] and receiving ART [aHR = 0.2 2(CI 95% 0.21-0.23)] reduced the risk of death.
conclusionsHIV-infected subjects should be screened for TB at care entry, to minimize diagnosis and treatment delays when active TB is present or to increase the odds of being offered latent TB infection therapy to prevent TB. On the other hand, TB cases should be promptly tested for HIV. All those will contribute to reduce mortality among people living with AIDS.
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