Tuberculosis (TB) is among the most relevant communicable diseases in terms of global public health. In Brazil, it is currently the second leading cause of death from infectious agents, second only to COVID-19, according to the Epidemiological Bulletin of the Ministry of Health. Among the most vulnerable groups are People Living with HIV (PLHIV), whose coinfection worsens the clinical condition and therapeutic challenges when adherence to antiretroviral therapy (ART) is lacking. Therefore, this study aimed to analyze the epidemiological profile of tuberculosis-HIV coinfection (TB-HIV) in the state of Pernambuco. This is an ecological study with a descriptive and analytical approach, based on retrospective data from 2013 to 2023. Information was obtained from the Sistema de Informação de Agravos de Notificação (SINAN). All reported cases of TB associated with HIV in the state were included, covering patients of all age groups, with analysis of demographic variables and treatment adherence. From 2013 to 2023, 7,289 cases of TB-HIV coinfection were recorded in Pernambuco. The highest notification percentages occurred in 2022 (10.4%) and 2023 (10.5%), while the lowest were observed in 2020 (7.4%) and 2015 (8.6%). Most diagnoses occurred in males (70.6%). Regarding race/color, mixed-race (“pardo”) individuals predominated, accounting for 60.2% of cases. Regarding treatment, 31.5% of patients used ART, while 18.8% did not; the remaining cases were recorded as white/unknown. Among those without ART use, an increasing trend in notifications was observed ‒ from 2 cases in 2013 to 173 in 2021 ‒ alongside a reduction in records lacking treatment information (from 670 cases in 2013 to 216 in 2021). The analyzed data reveal a predominance of coinfection among men, mixed-race individuals, and cases with missing information on antiretroviral use. The increase in the number of patients without recorded ART use may reflect both improvements in epidemiological surveillance and a possible increase in TB-HIV incidence. Additionally, the drop in cases in 2020 followed by an increase in subsequent years may indicate underreporting during the critical period of the COVID-19 pandemic.
Dantas et al. (Sun,) studied this question.