摘要
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 informa-tion 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(C/s),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%Cl: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 publ
基金
The study was supported by the fund of the Shanghai Natural Science Foundation(23ZR1464000,23ZR1463900)
the International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion from Shanghai Municipality Government(21410750200)
Medical Innovation Research Special Project of the Shanghai 2021"Science and Technology Innovation Action Plan"(21Y11922500,21Y11922400)
the Three-year Action Plan for Promoting Clinical Skills and Innovation Ability of Municipal Hospitals(SHDC-2022CRS039)
the Talent Fund of Longhua Hospital affliated to Shanghai University of Traditional Chinese Medicine(LH001.007)
the Bill&Melinda Gates foundation.The Funders had no role in the study design or in the collection,analysis,and interpretation of the data,writing of the report,or decision to submit the article for publication.
