Incidence of opportunistic infections in a Brazilian series of patients with AIDS (letter)

AIDS is characterized by the presentation of opportunistic infections. However different countries present different incidence rates of these infections due to varying prevalence of diseases and differences as to who becomes infected. In Brazil the U.S. pattern seems to be reproduced: AIDS affects predominantly homosexuals hemophiliacs intravenous drug abusers and persons having received blood transfusions as opposed to countries such as Africa or Haiti where a significant number of heterosexuals have also become infected. The opportunistic infections diagnoses and incidence rates were measured for 52 patients received in a clinic for transmissible diseases in Sao Paolo from February 1983 - May 1986. Average number of infections/patient while alive was 1.2. Time of survival after admission varied from 3 days to 1 year and 8 months. Determination of AIDS by anti-HIV tests was 100% accurate for 36 patients involved. A significant part of the differences between this series and others may be a result of less diagnostic capacity and lack of laboratory resources and experience such as in establishing infestation by cryptosporidium. A clear difference in the number of pneumocystis carinii infections (39.5%) compared to the North American series (71%) was probably related to the smaller number of pulmonary biopsies and alveolar lavages that could be performed and that would have isolated the parasite. Quite a number of infections some treatable were only detected after autopsy. It is considered of fundamental importance that necroscopic examinations are performed routinely in order that all infections are diagnosed and that in each case it is determined why it was not possible to diagnose the infection while the patient was still alive.