Mortality of children and adolescents co-infected with tuberculosis and HIV: a systematic review and meta-analysis.

IF 3.4 2区医学 Q3 IMMUNOLOGY

AIDS Pub Date : 2024-07-01 Epub Date: 2024-03-15 DOI:10.1097/QAD.0000000000003886

Fei-Hong Hu, Xiao-Lei Tang, Meng-Wei Ge, Yi-Jie Jia, Wan-Qing Zhang, Wen Tang, Lu-Ting Shen, Wei Du, Xiao-Peng Xia, Hong-Lin Chen

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引用次数: 0

Abstract

Objective: Children and adolescents with HIV infection are well known to face a heightened risk of tuberculosis. However, the exact mortality rates and temporal trends of those with HIV-tuberculosis (TB) co-infection remain unclear. We aimed to identify the overall mortality and temporal trends within this population.

Methods: PubMed, Web of Science, and Embase were employed to search for publications reporting on the mortality rates of children and adolescents with HIV-TB co-infection from inception to March 2, 2024. The outcome is the mortality rate for children and adolescents with HIV-TB co-infection during the follow-up period. In addition, we evaluate the temporal trends of mortality.

Results: During the follow-up period, the pooled mortality was 16% [95% confidence interval (CI) 13-20]. Single infection of either HIV or TB exhibit lower mortality rates (6% and 4%, respectively). We observed elevated mortality risks among individuals aged less than 12 months, those with extrapulmonary TB, poor adherence to ART, and severe immunosuppression. In addition, we observed a decreasing trend in mortality before 2008 and an increasing trend after 2008, although the trends were not statistically significant ( P = 0.08 and 0.2 respectively).

Conclusions: Children and adolescents with HIV-TB co-infection bear a significant burden of mortality. Timely screening, effective treatment, and a comprehensive follow-up system contribute to reducing the mortality burden in this population.

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同时感染结核病和艾滋病毒的儿童和青少年的死亡率：系统回顾和荟萃分析。

目的：众所周知，感染艾滋病毒的儿童和青少年面临着更高的结核病风险。然而，HIV-结核病合并感染者的确切死亡率和时间趋势仍不清楚。我们旨在确定这一人群的总体死亡率和时间趋势：方法：我们利用 PubMed、Web of Science 和 Embase 搜索了从开始到 2024 年 3 月 2 日期间报道合并感染 HIV-TB 的儿童和青少年死亡率的出版物。结果为随访期间合并感染 HIV-TB 的儿童和青少年的死亡率。此外，我们还评估了死亡率的时间趋势：在随访期间，总死亡率为 16%（95% CI 13-20）。单次感染艾滋病毒或结核病的死亡率较低（分别为 6% 和 4%）。我们观察到，年龄小于 12 个月、患有 EPTB、抗逆转录病毒疗法依从性差和严重免疫抑制的患者的死亡风险较高。此外，我们还观察到死亡率在 2008 年前呈下降趋势，2008 年后呈上升趋势，但这一趋势在统计学上并不显著（P = 0.08 和 0.2）：结论：合并感染艾滋病毒和结核病的儿童和青少年承受着沉重的死亡负担。及时筛查、有效治疗和全面的随访系统有助于减轻这一人群的死亡负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AIDS 医学-病毒学

CiteScore

5.90

自引率

5.30%

发文量

478

审稿时长

3 months

期刊介绍： Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.