Tuberculose e coinfecção com HIV no Brasil (2002 a 2022): um estudo de série temporal

Abstract

Tuberculosis (TB) remains a significant public health challenge in Brazil, particularly in the context of TB-HIV coinfection. This study conducted a time series analysis from 2002 to 2022 based on data from Brazil's national health information systems to evaluate the impacts of public health policies, including the expansion of the Family Health Strategy (ESF), on the epidemiology of TB and TB-HIV coinfection. Using SARIMAX models, the incidence curves of TB and TB-HIV were analyzed alongside socioeconomic factors and health system interventions. The results indicated a statistically significant downward trend in TB incidence until 2017, followed by stabilization, with notable demographic disparities and greater vulnerability among men and young adults. HIV testing in TB patients increased significantly, rising from 24.6% to 85.6% in 2022. However, TB-HIV coinfection incidence varied throughout the series, with specific periods of increase, possibly influenced by improved diagnostic access. The correlations revealed stronger associations between health interventions and TB incidence reduction in women compared to men. The study also identified structural challenges exacerbated by the COVID-19 pandemic, which disrupted TB diagnosis and treatment. While Brazil has made progress in HIV management through public policies ensuring access to prevention and antiretroviral therapy, gaps remain in addressing TB and coinfections among marginalized populations. This work aims to demonstrate that enhanced integration of TB and HIV programs, expanded social policies, and investment in technological innovations are essential to achieving sustainable public health outcomes.