EPIDEMIOLOGICAL PROFILE AND OCCURRENCE OF DEATHS IN PEOPLE LIVING WITH HIV/AIDS: CACHEXIA ASSOCIATED WITH HIGHER MORTALITY

Abstract

Introduction: The epidemic related to the human immunodeficiency virus (HIV), which causes Acquired Immunodeficiency Syndrome (AIDS), represents a public health problem due to its rapid geographic spread, the possibility of metabolic complications resulting from its chronicity, and the reduced life expectancy of individuals who do not receive timely treatment. Universal access to health services and antiretroviral therapy has been essential for increasing the survival of people living with HIV/AIDS (PLWHA). However, the incidence of chronic comorbidities has increased proportionally. Cachexia is an important condition at the time of notification and is believed to be associated with poorer prognoses, such as mortality. Therefore, it is necessary to investigate the survival of PLWHA in this context. Objective: To evaluate the relationship between cachexia and mortality among PLWHA. Method: This is a retrospective, observational epidemiological study with a quantitative approach, based on secondary data from the Epidemiological Surveillance Center of the State Tropical Diseases Hospital Dr. Anuar Auad (HDT), obtained from the Notifiable Diseases Information System (SINAN) between 2018 and 2022. Investigated the relationship between cachexia and mortality to help inform future intervention perspectives for this population. Results: Among 3,097 notified individuals, males predominated (71%), and the most frequent age group was 30 to 59 years. More than half of the sample had CD4+ T lymphocyte counts below 350 cells/mm³ (56%), a proportion that reached 79% among individuals with cachexia. Overall, 87.7% were alive, 11.9% died due to HIV/AIDS, and 0.4% died from other causes. Among the 1,103 cases with cachexia, 78.9% were alive and 21.1% progressed to death. Logistic regression analysis showed a statistically significant association between cachexia and mortality (OR = 1.01; 95% CI: 1.004–1.023; p = 0.007), indicating a proportionally higher risk of death in this subgroup. Conclusion: The presence of cachexia was associated with higher proportional mortality among PLWHA, reinforcing the importance of developing strategies for the prevention and management of cachexia in this population.