Epidemiological features and temporal trends of the co-infection between HIV and tuberculosis, 1990-2021: findings from the Global Burden of Disease Study 2021.

IF 8.1 1区医学 Infectious Diseases of Poverty Pub Date : 2024-08-16 DOI:10.1186/s40249-024-01230-3

Shun-Xian Zhang, Ji-Chun Wang, Jian Yang, Shan Lv, Lei Duan, Yan Lu, Li-Guang Tian, Mu-Xin Chen, Qin Liu, Fan-Na Wei, Xin-Yu Feng, Guo-Bing Yang, Yong-Jun Li, Yu Wang, Xiao-Jie Hu, Ming Yang, Zhen-Hui Lu, Shao-Yan Zhang, Shi-Zhu Li, Jin-Xin Zheng

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Abstract

Background: The co-infection of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and tuberculosis (TB) poses a significant clinical challenge and is a major global public health issue. This study aims to elucidate the disease burden of HIV-TB co-infection in global, regions and countries, providing critical information for policy decisions to curb the HIV-TB epidemic.

Methods: The ecological time-series study used data from the Global Burden of Disease (GBD) Study 2021. The data encompass the numbers of incidence, prevalence, mortality, and disability-adjusted life year (DALY), as well as age-standardized incidence rate (ASIR), prevalence rate (ASPR), mortality rate (ASMR), and DALY rate for HIV-infected drug-susceptible tuberculosis (HIV-DS-TB), HIV-infected multidrug-resistant tuberculosis (HIV-MDR-TB), and HIV-infected extensively drug-resistant tuberculosis (HIV-XDR-TB) from 1990 to 2021. from 1990 to 2021. The estimated annual percentage change (EAPC) of rates, with 95% confidence intervals (CIs), was calculated.

Results: In 2021, the global ASIR for HIV-DS-TB was 11.59 per 100,000 population (95% UI: 0.37-13.05 per 100,000 population), 0.55 per 100,000 population (95% UI: 0.38-0.81 per 100,000 population), for HIV-MDR-TB, and 0.02 per 100,000 population (95% UI: 0.01-0.03 per 100,000 population) for HIV-XDR-TB. The EAPC for the ASIR of HIV-MDR-TB and HIV-XDR-TB from 1990 to 2021 were 4.71 (95% CI: 1.92-7.59) and 13.63 (95% CI: 9.44-18.01), respectively. The global ASMR for HIV-DS-TB was 2.22 per 100,000 population (95% UI: 1.73-2.74 per 100,000 population), 0.21 per 100,000 population (95% UI: 0.09-0.39 per 100,000 population) for HIV-MDR-TB, and 0.01 per 100,000 population (95% UI: 0.00-0.03 per 100,000 population) for HIV-XDR-TB in 2021. The EAPC for the ASMR of HIV-MDR-TB and HIV-XDR-TB from 1990 to 2021 were 4.78 (95% CI: 1.32-8.32) and 10.00 (95% CI: 6.09-14.05), respectively.

Conclusions: The findings indicate that enhancing diagnostic and treatment strategies, strengthening healthcare infrastructure, increasing access to quality medical care, and improving public health education are essential to combat HIV-TB co-infection.

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1990-2021 年艾滋病毒与结核病合并感染的流行病学特征和时间趋势：2021 年全球疾病负担研究的结果。

背景：人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）和结核病（TB）的合并感染是一项重大的临床挑战，也是一个重大的全球公共卫生问题。本研究旨在阐明全球、各地区和各国艾滋病病毒与结核病合并感染的疾病负担，为遏制艾滋病病毒与结核病流行的政策决策提供重要信息：这项生态时间序列研究使用了 2021 年全球疾病负担（GBD）研究的数据。这些数据包括发病率、流行率、死亡率和残疾调整生命年（DALY），以及艾滋病毒感染者的年龄标准化发病率（ASIR）、流行率（ASPR）、死亡率（ASMR）和残疾调整生命年（DALY）、从 1990 年到 2021 年，HIV 感染的药物敏感性结核病（HIV-DS-TB）、HIV 感染的耐多药结核病（HIV-MDR-TB）和 HIV 感染的广泛耐药结核病（HIV-XDR-TB）的年龄标准化发病率（ASIR）、流行率（ASPR）、死亡率（ASMR）和 DALY 率。从 1990 年到 2021 年。结果表明：在 2021 年，全球结核病的 ASIR 为 1.5%：2021 年，全球艾滋病毒-DS-结核病的 ASIR 为每 10 万人 11.59 例（95% 置信区间：每 10 万人 0.37-13.05 例），艾滋病毒-MDR-结核病为每 10 万人 0.55 例（95% 置信区间：每 10 万人 0.38-0.81 例），艾滋病毒-XDR-结核病为每 10 万人 0.02 例（95% 置信区间：每 10 万人 0.01-0.03 例）。从 1990 年到 2021 年，HIV-MDR-TB 和 HIV-XDR-TB 的 ASIR 的 EAPC 分别为 4.71（95% CI：1.92-7.59）和 13.63（95% CI：9.44-18.01）。2021 年，HIV-DS-TB 的全球 ASMR 为每 10 万人 2.22 例（95% UI：每 10 万人 1.73-2.74 例），HIV-MDR-TB 为每 10 万人 0.21 例（95% UI：每 10 万人 0.09-0.39 例），HIV-XDR-TB 为每 10 万人 0.01 例（95% UI：每 10 万人 0.00-0.03 例）。从 1990 年到 2021 年，HIV-MDR-TB 和 HIV-XDR-TB 的 ASMR 的 EAPC 分别为 4.78（95% CI：1.32-8.32）和 10.00（95% CI：6.09-14.05）：研究结果表明，加强诊断和治疗策略、强化医疗保健基础设施、增加获得优质医疗保健的机会以及改善公共卫生教育，对于防治艾滋病毒与结核病合并感染至关重要。

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来源期刊

Infectious Diseases of Poverty INFECTIOUS DISEASES-

自引率

1.20%

发文量

368

期刊介绍： Infectious Diseases of Poverty is an open access, peer-reviewed journal that focuses on addressing essential public health questions related to infectious diseases of poverty. The journal covers a wide range of topics including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies and application. It also considers the transdisciplinary or multisectoral effects on health systems, ecohealth, environmental management, and innovative technology. The journal aims to identify and assess research and information gaps that hinder progress towards new interventions for public health problems in the developing world. Additionally, it provides a platform for discussing these issues to advance research and evidence building for improved public health interventions in poor settings.