Prevalence of coinfections in women living with human immunodeficiency virus in Northeast Brazil

Silva, Brenda Evelin Barreto da; Santos, Victor Santana; Santos, Ingrid Emmily Reis; Batista, Marcus Vinicius de Aragão; Gonçalves, Leila Luiza Conceição; Lemos, Lígia Mara Dolce de

doi:10.1590/0037-8682-0282-2019

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Short Communication • Rev. Soc. Bras. Med. Trop. 53 • 2020 • https://doi.org/10.1590/0037-8682-0282-2019 linkcopy

Prevalence of coinfections in women living with human immunodeficiency virus in Northeast Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

INTRODUCTION: Despite the success of antiretrovirals, human immunodeficiency virus (HIV) coinfections continue to cause mortality. We investigated the prevalence of coinfections in women with HIV/acquired immunodeficiency syndrome in Sergipe, Brazil.

METHODS: We conducted a cross-sectional study. The coinfections investigated were syphilis, hepatitis B and C, toxoplasmosis, rubella, tuberculosis, and cytomegalovirus.

RESULTS: Among the 435 women, 85 (19.5%) had coinfections. The most prevalent was HIV/syphilis, followed by tuberculosis, toxoplasmosis, hepatitis C, hepatitis B, and rubella. Additionally, 300 (96.2%) were seropositive for cytomegalovirus immunoglobulin G.

CONCLUSIONS: Despite significant progress in the treatment for people with HIV, coinfections continued to affect this population.

Keywords:
Coinfection; HIV; Women

Characteristics	N^c	%
Age group (years old) (n= 435)
13-25	63	14.5
26-49	298	68.5
≥50	74	17.0
Years of education (n= 431)
≤8	380	88.2
>8	51	11.8
Race (n= 396)
White	60	15.3
Black	120	30.5
Mixed	213	54.2
Conjugal union (n= 414)	280	67.6
Occupation (n= 435)
Employed	133	30.6
Unemployed	77	17.7
Benefit salary^b	96	22.0
Housewives/students	129	29.7
Household income (n= 432)
No income	33	7.6
1-2 salaries	338	78.3
>2 salaries	61	14.1
Sexual partner (n= 435)
Steady partner	274	63.0
Casual partner	28	6.4
Steady and casual partner	4	0.9
No partner	129	29.7
Number of sexual partners in the last year (n= 401)
No partner	75	18.7
1 or 2	301	75.1
>2	25	6.2
HIV exposure category (n= 435)
Sexual intercourse	329	75.6
Vertical transmission	7	1.6
Unknown	99	22.8
Drug use (n= 433)	78	18.0
Sex for money (n= 430)	45	10.5
Condon use (n= 409)	172	42.1
First sexual intercourse ≤15 years (n= 421)	191	45.4
Number of pregnancies
Nulligravid	28	6.4
1-3	264	61.0
≥4	141	32.6
Number of deliveries (n= 433)
Nulliparous	54	12.5
1-3	284	65.6
≥4	95	21.9
Abortion (n= 432)	167	38.7
Time of HIV diagnosis ≥ 5 years (n=435)	228	52.4
CD4+ T-lymphocyte ≥ 350 (cells/μl) (n= 401)	309	77.1
HIV viral load < 1000 copies/ml (n= 403)	309	76.7
Antiretroviral use (n= 433)	414	95.6

			Time of HIV diagnosis
	Prevalence		< 5 years		≥ 5 years
Coinfections	N^f	%	N^f	%	N^f	%	P-value^d
Cytomegalovirus (IgG ^b ) (n= 312)
Reagent	300	96.6	182	60.7	118	39.3	0.233^e
Non-reagent			5	41.7	7	58.3
Rubella (IgG) (n=280)
Reagent	252	90.0	170	67.5	82	32.5	0.065
Non-reagent			14	50.0	14	50.0
Rubella (IgM ^c ) (n=280)
Reagent	5	1,8	3	60.0	2	40.0	1.0^e
Non-reagent			181	65.8	94	34.3
Toxoplasmosis (IgG) (n=340)
Reagent	242	71.2	148	61.2	94	38.8	0.736
Non-reagent			58	59.2	40	40.8
Toxoplasmosis (IgM) (n=340)
Reagent	13	3.8	9	69.2	4	30.8	0.516
Non-reagent			197	60.2	130	39.8
Syphilis (n=419)
Yes	38	9.1	22	57.9	16	42.1	0.330
No			189	49.6	192	50.4
Tuberculosis (n=435)
Yes	17	3.9	4	23.5	13	76.5	0.025
No			214	51.2	204	48.8
Hepatitis B (n=394)
Reagent	9	2.3	5	55.6	4	44.4	1.0^e
Non-reagent			202	52.5	183	47.5
Hepatitis C (n=401)
Reagent	10	2.5	1	10.0	9	90.0	0.008^e
Non-reagent			209	53.5	182	46.5

	Coinfection^b
	Presence		Absence
Variables	N^e	%	N^e	%	PR^c	95% CI^d
Race/ethnicity (n= 393)
Black	34	28.4	86	71.6	1.58	0.75-3.33
Mixed	33	15.5	180	84.5	0.73	0.35-1.57
White	12	20.0	48	80.0	1	-
Schooling (n=431)
≤ 8 years	76	20.0	304	80.0	1.17	0.54-2.50
> 8 years	9	17.6	42	82.4	1	-
Living place (n=431)
Rural	13	17.8	60	82.2	1.16	0.60-2.23
Urban	72	20.1	286	79.9	1	-
Inadequate housing (n=435)
Yes	14	19.7	57	80.3	1.01	0.53-1.92
No	71	19.5	293	80.5	1	-
Income (n=432)
No income	6	18.2	27	81.8	0.92	0.36-2.29
With income	78	19.5	321	80.5	1	-
HIV exposure category (n=411)
Sexual intercourse	69	20.9	260	79.1	1.48	0.80-2.73
Vertical transmission	1	14.3	6	85.7	0.93	0.10-8.31
Unknown	15	15.2	84	84.8	1	-
Age at first sexual intercourse (years old) (n=421)
≤ 15	44	23.0	147	77.0	1.51	0.93-2.45
> 15	38	16.5	192	83.5	1	-
Sex for money (n=430)
Yes	13	28.9	32	71.1	1.76	0.88-3.50
No	72	18.7	313	81.3	1	-
Drug use (n=433)
Yes	16	23.2	53	76.8	1.33	0.71-2.49
No	57	18.5	251	81.5	1	-
Time of HIV diagnosis (years) (n=435)
< 5	40	18.4	178	81.6	1	-
≥ 5	45	20.7	172	79.3	1.16	0.72-1.87

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[TFN1] ^aHIV, human immunodeficiency virus. ^bBenefit salary: illness aid, unemployed benefit, retired. ^cThe number of women in each category may not add up to 435 due to missing information.