Mortality trends for diabetes mellitus, hypertension and cardiovascular disease among people living with and without HIV in Brazil during the COVID-19 pandemic, 2020–2022

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2026-08-03 Epub Date: 2026-04-08 DOI:10.1111/hiv.70240

Tatyellen Natasha da Costa Oliveira, Rodrigo C. Moreira, Luiz Max Carvalho, Flávio Codeço Coelho, Marcelo Ferreira da Costa Gomes, Leonardo S. Bastos, Laís Picinini Freitas, Antonio G. Pacheco

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Abstract

Introduction

People living with HIV (PLWH) face an increasing burden of non-AIDS-related chronic conditions. However, how the COVID-19 pandemic affected chronic disease-related mortality in this population remains unclear. We assessed changes in mortality among PLWH in Brazil during the COVID-19 pandemic.

Methods

We conducted a nationwide analysis using Brazil's Mortality Information System, including adults aged ≥18 years with and without HIV mentioned on death certificates from 2016 to 2022. Age- and sex-adjusted mortality ratios (aMRs) were estimated for all-cause mortality and for deaths associated with diabetes mellitus (DM), hypertension (HTN) and cardiovascular disease (CVD) using Poisson generalized linear mixed models, with the pre-pandemic period 2016–2019 used as the reference.

Results

Between 2016 and 2022, 90 888 deaths occurred among PLWH and 9 723 490 among individuals without HIV. Among PLWH, adjusted all-cause mortality ratios were lower in 2020 (aMR 0.918; 95% CI 0.900–0.936) and 2022 (aMR 0.950; 95% CI 0.932–0.968), while estimates for 2021 were close to the reference period. In contrast, individuals without HIV experienced increased mortality in 2020 (aMR 1.106; 95% CI 1.104–1.108), 2021 (aMR 1.269; 95% CI 1.267–1.272) and 2022 (aMR 1.029; 95% CI 1.027–1.031). Among PLWH, mortality associated with DM (aMRs 1.573–1.666), HTN (aMRs 1.738–1.978) and CVD (aMRs 1.242–1.377) increased consistently across all pandemic years. Among individuals without HIV, chronic disease-related mortality showed greater temporal variability, with increases in 2020 and 2021 followed by reductions in 2022.

Conclusions

Chronic disease-related mortality increased persistently among PLWH during the COVID-19 pandemic, contrasting with declining trends in the general population. These results emphasize distinct mortality dynamics among PLWH during public health crises.

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2020-2022年2019冠状病毒病大流行期间巴西艾滋病毒感染者和非艾滋病毒感染者糖尿病、高血压和心血管疾病死亡率趋势

HIV感染者（PLWH）面临着越来越多的非艾滋病相关慢性疾病负担。然而，COVID-19大流行如何影响这一人群中与慢性病相关的死亡率仍不清楚。我们评估了COVID-19大流行期间巴西PLWH死亡率的变化。方法：我们使用巴西的死亡率信息系统进行了全国范围的分析，包括2016年至2022年死亡证明上提到的年龄≥18岁的感染和未感染艾滋病毒的成年人。使用泊松广义线性混合模型，以2016-2019年大流行前时期为参考，估计了全因死亡率以及糖尿病（DM）、高血压（HTN）和心血管疾病（CVD）相关死亡的年龄和性别调整死亡率（aMRs）。结果：2016年至2022年期间，艾滋病病毒感染者中有90888人死亡，未感染艾滋病病毒者中有9723490人死亡。在PLWH中，调整后的全因死亡率在2020年（aMR 0.918; 95% CI 0.900-0.936）和2022年（aMR 0.950; 95% CI 0.932-0.968）较低，而2021年的估计值接近参考期。相比之下，未感染艾滋病毒的个体在2020年（aMR 1.106; 95% CI 1.104-1.108）、2021年（aMR 1.269; 95% CI 1.267-1.272）和2022年（aMR 1.029; 95% CI 1.027-1.031）的死亡率增加。在PLWH中，DM （aMRs 1.573-1.666）、HTN （aMRs 1.738-1.978）和CVD （aMRs 1.242-1.377）相关的死亡率在所有大流行年份持续增加。在未感染艾滋病毒的个体中，慢性病相关死亡率表现出更大的时间变异性，在2020年和2021年上升，然后在2022年下降。结论：在COVID-19大流行期间，PLWH中慢性病相关死亡率持续上升，而普通人群呈下降趋势。这些结果强调了公共卫生危机期间PLWH中明显的死亡率动态。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.