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TRENDS IN OVERALL OPPORTUNISTIC ILLNESSES, PNEUMOCYSTIS CARINIIPNEUMONIA, CEREBRAL TOXOPLASMOSIS AND MYCOBACTERIUMAVIUM COMPLEX INCIDENCE RATES OVER THE 30 YEARS OF THE HIV EPIDEMIC: A SYSTEMATIC REVIEW
Infections
Opportunistic infection
Acquired immunodeficiency
Syndrome
Incidence
Opportunistic Infections
Acquired Immunodeficiency Syndrome
Syndrome
Incidence
Affilliation
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil
Abstract
Background: The natural history of HIV infection has changed dramatically after theintroduction of highly active antiretroviral therapy. Currently, opportunistic illnesses stillrepresent a major cause of death and hospitalization in this population. In this study,we review the trends in opportunistic illnesses incidence rates and compare the resultsobserved in high-income settings with that for low/middle-income settings, with specialattention given to studies from Brazil.Methods: We systematically searched Pubmed, Web of Science, Lilacs and Google scholarfor publications on HIV associated opportunistic illness. Studies reporting rates based onperson-time for all opportunistic illnesses and/or the three opportunistic infections ofinterest, namely, Pneumocystis carinii pneumonia, cerebral toxoplasmosis, and Mycobacteriumavium complex were included.Results: Significant reductions in the incidence rates were demonstrated for opportunisticillnesses overall and also for the specific opportunistic infections included in the presentstudy, both in high and low/middle-income settings. Out of the 37 studies included in thepresent review, almost 70% were from high-income settings. All the studies conducted inlow/middle-income settings were single center studies and four were from Brazil. We foundno study from Brazil reporting annual incidence rates of opportunistic illnesses.Conclusions: Opportunistic illnesses remain an important public health problem. To betterguide health policies in low/middle-income settings, multicenter cohort studies should beencouraged. Studies from Brazil are urgently needed to assess the current burden of oppor-tunistic illnesses in our population and to support the planning of HIV/AIDS health careservices organization.
Keywords
AIDS-related opportunisticInfections
Opportunistic infection
Acquired immunodeficiency
Syndrome
Incidence
DeCS
AIDS-Related Opportunistic InfectionsOpportunistic Infections
Acquired Immunodeficiency Syndrome
Syndrome
Incidence
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