Article Text
Abstract
Introduction The objective of this study was to analyse the survival of patients with coinfection AIDS/HCV according to sociodemographic, epidemiological, clinical, and the utilisation of health services in the South and Southeast of Brazil.
Methods This is a retrospective cohort study. The sample of medical records of individuals older than 13 years diagnosed with AIDS, reported in the SINAN in 1998 and 1999 with follow-up of 10 years.
Results Of the 2091 cases of AIDS in over 13 years studied, 307 (14,7%) were diagnosed with Hepatitis C and 223 (72.6%) were male. After analysis of the survival curves by KaplanMeier method a multiple regression model of Cox was adjusted. The variables positively associated with longer survival were: being female (HR=0.68 CI95%%: 0.510.83), higher education (HR=0.51 CI95%%: 0.35–0.76), CD4 diagnostic criteria (HR=0.57 CI95%%: 0.46–0.72). Variables associated negatively with survival were: age ≥60 years (HR=2.47 CI95%%: 1.38–4.26), irregular use of ARV (HR=8,71 CI95%%: 6.72–11.27), not having consulted with other health professionals than physician and/or nurse (HR=1.25 CI95%%: 1.031,53), coinfection AIDS-tuberculosis (HR 1.42 CI95%: 1.17–1.71) and one or more opportunistic infections (HR=1,37 95% CI: 1.21–1.55). Patients with AIDSHCV coinfection had lower survival than those without coinfection. The cumulative survival in accordance with the KaplanMeier method was 82% in non coinfected and 78% in coinfected after 60 months of the diagnosis of AIDS. However coinfection AIDS/HCV didn´t remain in the final model as a predictor of survival.
Conclusion Despite the progress in HIV treatment and control, some challenges remain, including overcoming inequalities, early diagnosis, and ensuring the availability and adherence to treatment with drug combination with lower toxicity and ease intake. AIDS and Hepatitis C are two chronic diseases can be analysed as markers of quality of care and AIDS in Brazil.