PATIENTS WITH TUBERCULOSIS AND HIV IN BRAZIL: EPIDEMIOLOGICAL ANALYSIS OF A DECADE

TB-HIV coinfection is a serious public health problem in Brazil and an important cause of morbidity and mortality. TB is among the main opportunistic infections in people with HIV, whose immunosuppression significantly increases the risk of active TB. Although there have been advances in surveillance and control, analyzing patterns of this coinfection is crucial to evaluate public policies and remaining challenges. This study aims to analyze the temporal trend of tuberculosis cases among patients diagnosed with HIV in Brazil from 2014 to 2024. Observational epidemiological study, descriptive time series from 2014 to 2024. Individuals with tuberculosis who underwent diagnostic testing for HIV screening were selected. Data were collected using Tabnet, available in the Notifiable Diseases Information System (SINAN/DATASUS). During the period, there were 1,040,874 TB cases, of which 114,047 (11%) were HIV-positive. Annual distribution showed: According to SINAN/DATASUS, confirmed HIV-positive cases by diagnostic year were divided as follows: In 2014, 10,123 positive cases were recorded (11.9% of total), with a trend of slight reduction until 2016 (9,543 cases; 11.1%) and relative stability until 2019 (9,862 cases; 10.2%). The COVID-19 pandemic impacted notifications in 2020, with a drop to 8,616 positives (10%), followed by progressive recovery from 2021 (9,228 cases). In 2023–2024, there was a marked increase, reaching a record 14,424 positive cases (12.9% of total). In parallel, negative cases increased consistently from 54,170 (2014) to 81,243 (2024), except in 2020 due to pandemic underreporting. The proportion of “not performed” tests decreased over the years (22% in 2014 to 11% in 2024), as did “ignored” records (0.3%–0.5% annually), indicating improved data quality. The post-pandemic period (2022–2024) stood out for the concerning increase in TB-HIV cases, requiring reinforcement of prevention and integrated diagnostic strategies. The study reveals a concerning trend in TB-HIV coinfection in Brazil, with post-pandemic growth (14,424 cases in 2024) after a decline during COVID-19. Despite improvements in data quality, gaps remain that require strengthening integrated testing and treatment strategies to effectively control this dual burden of disease.