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Tuberculosis as opportunistic disease among AIDS in the city of Rio de Janeiro.
Silva G; Barreira D; Health Secretariat of Rio de Janeiro City, Rio de
January 30, 1997
Int Conf AIDS. 1996 Jul 7-12;11(1):165 (abstract no. Mo.C.1643). Unique

Objective: To evaluate the significance of tuberculosis (TB) as an opportunistic disease in AIDS cases reported in the city of Rio de Janeiro. Methods: All AIDS cases reported to the Health Secretariat of the city of Rio de Janeiro from 1982 to 1995 were studied, observing the prevalence of the main opportunistic diseases in the moment of reporting. The data back was analyzed with the software EPI-INFO (EPI6). Results: We observed an important increase in AIDS cases from 82 to 89 and a slighter from 90 to 95 when the trend was towards stabilization. Until 92 TB was the second prevalent opportunistic disease (OD) to candidiasis in the city of Rio de Janeiro. From this time on TB became the most prevalent OD followed by candidiasis and by pneumocystis carinii pneumonia (PCP), this latter being always the third prevalent one. In Brazil, till 92 candidiasis was the main AIDS related OD by the time of reporting followed by PCP and by TB (all kinds). From 93 on TB was the predominant OD followed by PCP and candidiasis. This picture remained unchangeable until the end of the studied period. Analyzing the trends for the city of Rio de Janeiro we observed that it points to an important increase of TB and PCP.Discussion: Tuberculosis in the city of Rio de Janeiro is more expressive as an opportunistic disease related to AIDS than in Brazil as a whole. Probably the high incidence of the disease in the municipality (160/100.000 inhab. against 65/100.000 inhab. to the country) is responsible for its significance when compared with the other opportunistic diseases. Concerning to the predominance of TB over candidiasis after 93 we should comment that the data of candidiasis were referred only to the disease of trachea, esophagus, bronchus and lungs (CDC criteria) not to oral disease. Another fact that could explain the increase of TB reported after 92 was the implementation of a training program in co-infection TB/HIV to health care professionals. Conclusions: Aiming to avoid the occurrence of the main OD in AIDS in the city of Rio de Janeiro one should: (1) implement the TB Control Program activities, and (2) implement AIDS Program prevention activities, like training for health care professionals and chemoprophylaxis for TB among AIDS patients. Efforts should also be dome to control PCP almost as high as TB in the spectrum of opportunistic diseases related with AIDS in Rio de Janeiro.

*Acquired Immunodeficiency Syndrome/COMPLICATIONS *Tuberculosis/COMPLICATIONS