02176nas a2200229   4500000000100000008004100001653001800042653002700060653000800087653000900095653001100104653001600115100002700131700001300158700001500171245007200186856009800258300001300356490000700369520155600376022001401932       2017                            d10aLeishmaniasis10aVisceral Leishmaniasis10aHIV10aAids10aBrazil10aCoinfection1 aLeite de Sousa-Gomes M1 aRomero G1 aWerneck GL00aVisceral leishmaniasis and HIV/AIDS in Brazil: Are we aware enough?  uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005772&type=printable  ae00057720 v113 a<p><strong>BACKGROUND: </strong>The urbanization of visceral leishmaniasis (VL) and the concurrent movement of the HIV infection to rural areas in Brazil are possible mechanisms associated with an increased number of Leishmania/HIV coinfected people. This study aimed to describe the clinical and epidemiological profile of VL/HIV coinfected patients and compare this profile to non-coinfected VL patients.</p>

<p><strong>METHODS: </strong>Cases of VL/HIV coinfection were obtained through a probabilistic record linkage of databases of VL and AIDS cases from the Brazilian Ministry of Health.</p>

<p><strong>RESULTS: </strong>We retrieved 760 cases of VL/HIV coinfection, most prevalent in adult males, with incidence ranging from 0.01 to 0.07 cases, per 100.000 population, in 2001 and 2010, respectively. Case-fatality rates were 27.3% in 2001 and 23.2% in 2010. Weakness, weight loss, cough, other associated infections and haemorrhagic phenomena were more commonly found among coinfected patients, which had a fatality rate three times higher as compared to the non-coinfected group. The relapse proportion was two times greater among coinfected (6.3%) than non-coinfected (3.1%).</p>

<p><strong>CONCLUSIONS: </strong>The results found herein contribute to the increase of knowledge of the epidemiological situation of VL/HIV coinfection in Brazil and reinforce the necessity of implementing specific strategies to improve early case detection and efficacious and less toxic treatment in order to achieve lower case-fatality rates.</p>
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