ABSTRACT Background: This study aimed to identify COVID-19 cases among people living with HIV (PLWH) in Brazil in 2020, describe their clinical, sociodemographic, and epidemiological profiles, and evaluate the factors associated with disease severity. Methods: This cross-sectional study used secondary data obtained from the Brazilian healthcare system. Probabilistic and deterministic data linkage methods were used to identify coinfected patients. Descriptive statistical analysis was conducted, and factors associated with severe cases were evaluated using Pearson's chi-squared test, Student's t-test, and logistic regression. Results: In 2020, 36,746 coinfections were identified, making it one of the largest coinfection databases described worldwide. In total, 4,502 (12.25%) patients had severe cases and 32,244 (87.75%) had non-severe cases. The covariates age (OR=1.05; 95% CI: 1.05-1.06), nonwhite ethnicity (OR=1.68; 95% CI: 1.56-1.81), history of AIDS diagnosis (OR=1.17; 95% CI: 1.08-1.28), recent HIV diagnosis (OR=5.47; 95% CI: 4.25-7.02), absence of antiretroviral therapy (OR=1.70; 95% CI: 1.57-1.84), CD4+ < 200 (OR=6.41; 95% CI: 5.09-8.08), detectable HIV viral load (OR=2.61; 95% CI: 2.21-3.05), ≥ 1 comorbidity (OR=4.09; 95% CI: 3.79-4.41), and ≥ 4 symptoms were associated with increased severity. Conclusions: Multiple factors were linked to severe COVID-19, including uncontrolled HIV infection, age > 50 years, comorbidities, and racial disparities. This study reinforces the importance of maintaining public policies focused on early HIV diagnosis, access and adherence to treatment, especially for minority ethnic groups, and focusing on premature aging in PLWH. Background COVID19 COVID 19 COVID-1 PLWH (PLWH 2020 clinical sociodemographic profiles severity Methods crosssectional cross sectional system conducted Pearsons Pearson s chisquared chi squared test Students Student ttest, ttest t t-test regression Results 36746 36 746 36,74 identified worldwide total 4502 502 4,50 12.25% 1225 12 25 (12.25% 32244 32 244 32,24 87.75% 8775 87 75 (87.75% nonsevere non OR=1.05 OR105 OR 05 (OR=1.05 95 CI 1.051.06, 105106 1.05 1.06 , 06 1.05-1.06) OR=1.68 OR168 68 (OR=1.68 1.561.81, 156181 1.56 1.81 56 81 1.56-1.81) OR=1.17 OR117 17 (OR=1.17 1.081.28, 108128 1.08 1.28 08 28 1.08-1.28) OR=5.47 OR547 5 47 (OR=5.47 4.257.02, 425702 4.25 7.02 7 02 4.25-7.02) OR=1.70 OR170 70 (OR=1.70 1.571.84, 157184 1.57 1.84 57 84 1.57-1.84) CD4 CD 20 OR=6.41 OR641 6 41 (OR=6.41 5.098.08, 509808 5.09 8.08 09 8 5.09-8.08) OR=2.61 OR261 2 61 (OR=2.61 2.213.05, 221305 2.21 3.05 21 3 2.21-3.05) OR=4.09 OR409 (OR=4.09 3.794.41, 379441 3.79 4.41 79 3.79-4.41) Conclusions COVID19, 19, infection years comorbidities disparities treatment groups COVID1 COVID- 202 3674 74 36,7 450 4,5 12.25 122 (12.25 3224 24 32,2 87.75 877 (87.75 OR=1.0 OR10 0 (OR=1.0 9 051 1.051.06 10510 105 1.0 106 1.05-1.06 OR=1.6 OR16 (OR=1.6 561 1.561.81 15618 156 1.5 181 1.8 1.56-1.81 OR=1.1 OR11 (OR=1.1 081 1.081.28 10812 108 128 1.2 1.08-1.28 OR=5.4 OR54 (OR=5.4 257 4.257.02 42570 425 4.2 702 7.0 4.25-7.02 OR=1.7 OR17 (OR=1.7 571 1.571.84 15718 157 184 1.57-1.84 OR=6.4 OR64 (OR=6.4 098 5.098.08 50980 509 5.0 808 8.0 5.09-8.08 OR=2.6 OR26 (OR=2.6 213 2.213.05 22130 221 2.2 305 3.0 2.21-3.05 OR=4.0 OR40 (OR=4.0 794 3.794.41 37944 379 3.7 441 4.4 3.79-4.41 367 36, 45 4, 12.2 (12.2 322 32, 87.7 (87.7 OR=1. OR1 (OR=1. 1.051.0 1051 10 1. 1.05-1.0 1.561.8 1561 15 18 1.56-1.8 1.081.2 1081 1.08-1.2 OR=5. OR5 (OR=5. 4.257.0 4257 42 4. 7. 4.25-7.0 1.571.8 1571 1.57-1.8 OR=6. OR6 (OR=6. 5.098.0 5098 5. 80 8. 5.09-8.0 OR=2. OR2 (OR=2. 2.213.0 2213 22 2. 30 3. 2.21-3.0 OR=4. OR4 (OR=4. 3.794.4 3794 37 44 3.79-4.4 12. (12. 87. (87. OR=1 (OR=1 1.051. 1.05-1. 1.561. 1.56-1. 1.081. 1.08-1. OR=5 (OR=5 4.257. 4.25-7. 1.571. 1.57-1. OR=6 (OR=6 5.098. 5.09-8. OR=2 (OR=2 2.213. 2.21-3. OR=4 (OR=4 3.794. 3.79-4. (12 (87 OR= (OR= 1.051 1.05-1 1.561 1.56-1 1.081 1.08-1 4.257 4.25-7 1.571 1.57-1 5.098 5.09-8 2.213 2.21-3 3.794 3.79-4 (1 (8 (OR 1.05- 1.56- 1.08- 4.25- 1.57- 5.09- 2.21- 3.79- (

Abstract INTRODUCTION HIV incidence estimates are essential to monitor the progress of prevention and control interventions. METHODS Data collected by Brazilian surveillance systems were used to derive HIV incidence estimates by age group (15-24; 25+) and sex from 1986 to 2018. This study used a back-calculation method based on the first CD4 count among treatment-naïve cases. Incidence estimates for the population aged 15 years or over were compared to Global Burden of Disease Study (GBD) estimates from 2000 to 2018. RESULTS Among young men (15-24 years), HIV incidence increased from 6,400 (95% CI: 4,900-8,400), in 2000, to 12,800 (95% CI: 10,800-15,900), in 2015, reaching incidence rates higher than 70/100,000 inhabitants and an annual growth rate of 3.7%. Among young women, HIV incidence decreased from 5,000 (95% CI: 4,200-6,100) to 3,200 (95% CI: 3,000-3,700). Men aged ≥25 years and both female groups showed significant annual decreases in incidence rates from 2000 to 2018. In 2018, the estimated number of new infections was 48,500 (95% CI: 45300-57500), 34,800 (95% CI: 32800-41500) men, 13,600 (95% CI: 12,500-16,000) women. Improvements in the time from infection to diagnosis and in the proportion of cases receiving antiretroviral therapy immediately after diagnosis were found for all groups. Comparison with GBD estimates shows similar rates for men with overlapping confidence intervals. Among women, differences are higher mainly in more recent years. CONCLUSIONS The results indicate that efforts to control the HIV epidemic are having an impact. However, there is an urgent need to address the vulnerability of young men.

RESUMO Objetivo: Analisar a distribuição dos serviços de saúde de atenção às hepatites virais e os casos notificados de hepatites virais segundo as regiões de saúde dos estados do Norte do Brasil. Método: Trata-se de pesquisa avaliativa, descritiva e quantitativa considerando os serviços de atenção e casos notificados de hepatites virais na região Norte do Brasil. Foram coletados dados do Cadastro Nacional de Estabelecimentos de Saúde e do Sistema de Informação de Agravos e Notificação. Utilizou-se estatística descritiva e georreferenciamento por meio de software para visualizar a distribuição espacial dos serviços e os casos notificados. Resultados: Os serviços são distribuídos de maneira diferenciada; testes rápidos apresentam-se capilarizados nos estados; demais exames para confirmar o diagnóstico e o tratamento são realizados em algumas regiões de saúde, com maior agrupamento de serviços nas capitais e suas cercanias. Verificam-se casos notificados de maneira pulverizada nas regiões, com áreas de maior concentração próximas aos serviços. Conclusão: A disponibilidade de serviços pode favorecer o acesso e a adoção de medidas de prevenção, diagnóstico e monitoramento de casos. Entretanto, peculiaridades organizacionais do sistema e serviços de saúde evidenciam fragilidades que repercutem no acesso e na integralidade da atenção às hepatites virais.

ABSTRACT Objective: To analyze the distribution of health care services for viral hepatitis and reported cases of viral hepatitis according to the health regions of Northern Brazil. Method: It is an evaluative, descriptive and quantitative research considering viral hepatitis care services and reported cases in the Northern region of Brazil, using data collected from the National Registry of Health Establishments and the Notifiable Diseases Information System. Descriptive statistics and georeferencing, through software, were used to demonstrate the spatial distribution of services and reported cases. Results: Viral hepatitis health services are distributed in a differentiated way; rapid tests are capillaries in the states; confirmatory tests and treatment are performed in some health regions, with a greater grouping of services in the capitals and their surroundings. Cases were reported across all regions, with areas of higher concentration near services. Conclusion: The availability of services can favor access to prevention, diagnosis and monitoring of cases. However, organizational peculiarities of the health system and services highlight fragilities that have repercussions on the access and entirety of viral hepatitis care.

RESUMO Objetivo: Analisar a distribuição dos serviços de saúde de atenção às hepatites virais e os casos notificados de hepatites virais segundo as regiões de saúde dos estados do Norte do Brasil. Método: Trata-se de pesquisa avaliativa, descritiva e quantitativa considerando os serviços de atenção e casos notificados de hepatites virais na região Norte do Brasil. Foram coletados dados do Cadastro Nacional de Estabelecimentos de Saúde e do Sistema de Informação de Agravos e Notificação. Utilizou-se estatística descritiva e georreferenciamento por meio de software para visualizar a distribuição espacial dos serviços e os casos notificados. Resultados: Os serviços são distribuídos de maneira diferenciada; testes rápidos apresentam-se capilarizados nos estados; demais exames para confirmar o diagnóstico e o tratamento são realizados em algumas regiões de saúde, com maior agrupamento de serviços nas capitais e suas cercanias. Verificam-se casos notificados de maneira pulverizada nas regiões, com áreas de maior concentração próximas aos serviços. Conclusão: A disponibilidade de serviços pode favorecer o acesso e a adoção de medidas de prevenção, diagnóstico e monitoramento de casos. Entretanto, peculiaridades organizacionais do sistema e serviços de saúde evidenciam fragilidades que repercutem no acesso e na integralidade da atenção às hepatites virais.

ABSTRACT Objective: To analyze the distribution of health care services for viral hepatitis and reported cases of viral hepatitis according to the health regions of Northern Brazil. Method: It is an evaluative, descriptive and quantitative research considering viral hepatitis care services and reported cases in the Northern region of Brazil, using data collected from the National Registry of Health Establishments and the Notifiable Diseases Information System. Descriptive statistics and georeferencing, through software, were used to demonstrate the spatial distribution of services and reported cases. Results: Viral hepatitis health services are distributed in a differentiated way; rapid tests are capillaries in the states; confirmatory tests and treatment are performed in some health regions, with a greater grouping of services in the capitals and their surroundings. Cases were reported across all regions, with areas of higher concentration near services. Conclusion: The availability of services can favor access to prevention, diagnosis and monitoring of cases. However, organizational peculiarities of the health system and services highlight fragilities that have repercussions on the access and entirety of viral hepatitis care.