title: Impact of public health strategies on reducing AIDS mortality in southern Brazil.
abstract: In Brazil, all patients who fulfill the criteria for AIDS have had free access to antiretroviral therapy since 1996. We performed this cross-sectional study to evaluate the causes of death among 643 HIV-infected patients over three non-consecutive years (2000, 2006, and 2010), using their epidemiological, clinical, and laboratory data. The causes of death were classified as AIDS-defining or non-AIDS-defining conditions. We observed a progressive increase in the prevalence of HIV infection over the study period, although there was also a decrease in the mortality rate for various groups, and especially among pediatric patients. An AIDS-defining condition was recorded as the cause of death for approximately 30% of the patients. There was also a high frequency (>70%) of infectious and parasitic diseases, including opportunistic infections, and the most common diagnoses were septicemia, pneumonia, tuberculosis, and pneumocystosis. Acute respiratory failure was the underlying cause of death in 30% of these cases. Despite advances in HIV therapy, the mortality rate remains high in Brazil. As few Brazilian studies have investigated HIV/AIDS-related mortality, it is important to evaluate and improve the mortality notification databases, in order to provide information regarding the effects of HIV and to guide the implementation of appropriate healthcare measures.
authors.affiliation: 1 Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil.|2 Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil.
authors.forename: Sonia M
authors.initials: SM
authors.lastname: Raboni
authors.affiliation: 1 Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil.|3 Secretaria Municipal de Saúde de Curitiba, Paraná, Curitiba, Brazil.
authors.forename: Clea E
authors.initials: CE
authors.lastname: Ribeiro
authors.affiliation: 4 Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil.
authors.forename: Sergio M
authors.initials: SM
authors.lastname: Almeida
authors.affiliation: 5 Faculdade Evangélica de Curitiba, Paraná, Curitiba, Brazil.
authors.forename: João Paulo M
authors.initials: JP
authors.lastname: Telles
authors.affiliation: 5 Faculdade Evangélica de Curitiba, Paraná, Curitiba, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Azevedo
authors.affiliation: 1 Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil.
authors.forename: Gustavo A
authors.initials: GA
authors.lastname: Schaitza
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000401:mortality*; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000401:mortality*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008297:Male; D015995:Prevalence
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS-defining conditions; HIV-related mortality; antiretroviral therapy