Tian Xuebin, Wang Chong, Hao Zhihao, Chen Jingjing, Wu Nanping
Cell Biology Research Platform, Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China.
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Front Reprod Health. 2024 Dec 10;6:1475498. doi: 10.3389/frph.2024.1475498. eCollection 2024.
To assess sex, age, regional differences, and the changing trend in human immunodeficiency virus and tuberculosis (HIV-TB) in different regions from 1990 to 2021, and project future trends.
Global Burden of Disease Study 2021 data were analyzed to assess HIV-TB incidence, death, prevalence, and DALY rates from 1990 to 2021, including different types of TB co-infections (drug-susceptible, multidrug-resistant, and extensively drug-resistant). Bayesian age-period-cohort models were used to forecast age-standardized DALY rates through 2035.
In 2021, there were approximately 1.76 million HIV-TB infections and 200,895 deaths globally. The highest burden of HIV-DS-TB and HIV-MDR-TB was found in Southern Sub-Saharan Africa, while HIV-XDR-TB was most prevalent in Eastern Europe. The co-infection burden was highest among individuals aged 30-49. Key risk factors were unsafe sex, drug use, and intimate partner violence, with regional variations. The global burden of HIV-TB remains high, and age-standardized DALY rates are expected to increase in the coming years, especially in regions with low socio-demographic indices (SDI).
The burden of HIV-TB co-infection correlates with the socio-demographic index (SDI): countries with a low SDI have a higher burden. Therefore, clinical diagnosis and treatment in such areas are more challenging and may warrant more attention. High death rates underscore the importance of early management.
评估1990年至2021年不同地区人类免疫缺陷病毒和结核病（HIV-TB）的性别、年龄、地区差异及变化趋势，并预测未来趋势。
分析2021年全球疾病负担研究数据，以评估1990年至2021年HIV-TB的发病率、死亡率、患病率和伤残调整生命年（DALY）率，包括不同类型的结核合并感染（药物敏感型、耐多药型和广泛耐药型）。使用贝叶斯年龄-时期-队列模型预测到2035年的年龄标准化DALY率。
2021年，全球约有176万例HIV-TB感染和200895例死亡。撒哈拉以南非洲南部HIV-DS-TB和HIV-MDR-TB负担最高，而HIV-XDR-TB在东欧最为普遍。合并感染负担在30-49岁人群中最高。主要危险因素为不安全的性行为、吸毒和亲密伴侣暴力，存在地区差异。HIV-TB的全球负担仍然很高，预计未来几年年龄标准化DALY率将上升，特别是在社会人口指数（SDI）较低的地区。
HIV-TB合并感染负担与社会人口指数（SDI）相关：SDI低的国家负担更高。因此，这些地区的临床诊断和治疗更具挑战性，可能需要更多关注。高死亡率凸显了早期管理的重要性。
