EPIDEMIOLOGICAL PROFILE OF VISCERAL LEISHMANIASIS X HIV CO-INFECTION IN THE STATE OF PARÁ FROM 2018 TO 2022

Abstract

Visceral Leishmaniasis (VL), the most severe form of the disease, when associated with HIV, has a high mortality rate due to immunosuppression, which increases the patient's vulnerability to opportunistic infections, relapses and therapeutic failures. Using data from the Notifiable Diseases Information System (Sinan-Net), the study analyzed 1. 495 cases of VL between 2018 and 2022, evaluating variables such as gender, age group, race, education, and clinical evolution, with the data processed in Microsoft Excel. The results indicated a predominance of Cutaneous Leishmaniasis (TL), which represented about 90% of the reported cases, however, the data do not show an association with HIV. Only VL showed results associated with HIV. Coinfection was more common in men of brown ethnicity, adults of working age and with low schooling, suggesting greater occupational exposure in risk areas and reflecting socioeconomic inequalities. Most of the coinfected patients were diagnosed by laboratory methods, which contributed to relatively high cure rates. However, coinfected patients had higher mortality compared to HIV-negative patients, with deaths directly associated with VL or indirect causes. In addition, an initial downward trend was noted in the number of reported VL cases until 2021, followed by an increase in 2022, which suggests possible changes in the epidemiological dynamics of the disease. Coinfection worsens the clinical outcomes of both conditions, making therapeutic management difficult. HIV-induced immunosuppression intensifies the severity of VL, while Leishmania infection accelerates immune decline in HIV patients. In summary, the study reinforces the strategic role of SINAN as a tool for epidemiological monitoring and formulation of health policies, contributing to the understanding of the dynamics of LV-HIV co-infection in Pará. The analysis emphasizes that effective coping requires integrated approaches that consider not only biological factors, but also social and structural factors, to achieve greater equity in health care.