The Shifting Landscape of HIV-Tuberculosis Co-Infection in the MENA Region with a Focus on Saudi Arabia: A Systematic Epidemiological Analysis over Three Decades.

IF 5.3 3区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases and Therapy Pub Date : 2026-05-03 DOI:10.1007/s40121-026-01358-9

Zikria Saleem, Masaad Saeed Almutairi, Huda Arooj, Faris S Alnezary

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引用次数: 0

Abstract

Introduction: The interaction between human immunodeficiency virus (HIV) and tuberculosis (TB) presents a persistent public health challenge, particularly with the emergence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB). The Middle East and North Africa (MENA) region shows complex TB patterns, and Saudi Arabia continues to face challenges in TB control within the regional context.

Methods: Using Global Burden of Disease (GBD) 2023 estimates, we analyzed age-standardized disability-adjusted life year (DALY) and incidence trends for HIV and drug-susceptible TB, MDR-TB, and XDR-TB in Saudi Arabia and the MENA region from 1990 to 2023. Temporal patterns were quantified using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC).

Results: Across MENA and Saudi Arabia, the burden of drug-susceptible TB increased during the 1990s to early 2000s and subsequently declined in 2023 (MENA age-standardized DALY rate [ASDR]: 6.60 in 1990, peaking at 13.11 in 1999, declining to 7.39 in 2023; Saudi Arabia ASDR: 13.63 in 1990, peaking at 20.56 in 2003, declining to 4.94 in 2023). A similar temporal pattern was observed for MDR-TB (MENA ASDR (Age-Standardized DALY Rate): 0.03 in 1990, peaking at 1.04 in 2002, declining to 0.40 in 2023; Saudi Arabia ASDR: 0.03 in 1990, peaking at 1.93 in 2003, declining to 0.33 in 2023). In contrast, XDR-TB showed an overall decline in MENA (ASDR: 1.72 in 1991, declining to 0.02 in 2023), while in Saudi Arabia, ASDR declined from 2.42 in 1991 to 0.02 in 2023. MENA estimates are presented to provide regional context and enable comparison with national trends in Saudi Arabia.

Conclusions: From 1990 to 2023, the TB burden among people with HIV in Saudi Arabia declined substantially, particularly for drug-susceptible TB, indicating progress in TB control and HIV management. Drug-resistant forms (MDR-TB and XDR-TB) showed complex trends with early increases followed by stabilization or gradual reductions in absolute burden.

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中东和北非地区艾滋病毒-结核病合并感染的变化情况，重点是沙特阿拉伯：三十年来系统的流行病学分析。

导语：人类免疫缺陷病毒（HIV）和结核病（TB）之间的相互作用是一个持续的公共卫生挑战，特别是随着耐多药结核病（MDR-TB）和广泛耐药结核病（XDR-TB）的出现。中东和北非地区显示出复杂的结核病模式，沙特阿拉伯在区域范围内继续面临结核病控制方面的挑战。方法：利用全球疾病负担（GBD） 2023估计数，分析1990年至2023年沙特阿拉伯和中东和北非地区艾滋病毒和药敏结核病、耐多药结核病和广泛耐药结核病的年龄标准化残疾调整生命年（DALY）和发病率趋势。利用Joinpoint回归对时间模式进行量化，估计年变化百分比（APC）和平均年变化百分比（AAPC）。结果：在中东和北非地区和沙特阿拉伯，药物敏感结核病的负担在20世纪90年代至21世纪初有所增加，随后在2023年有所下降（中东和北非地区年龄标准化DALY率[ASDR]: 1990年6.60,1999年达到峰值13.11,2023年降至7.39；沙特阿拉伯ASDR: 1990年13.63,2003年达到峰值20.56,2023年降至4.94）。耐多药结核病（MENA）的年龄标准化DALY率（ASDR）也有类似的时间模式：1990年为0.03,2002年达到峰值1.04,2023年降至0.40；沙特阿拉伯ASDR: 1990年为0.03,2003年达到1.93的峰值，2023年降至0.33)。相比之下，广泛耐药结核病在中东和北非地区总体下降（ASDR: 1991年为1.72,2023年降至0.02），而在沙特阿拉伯，ASDR从1991年的2.42降至2023年的0.02。提供中东和北非地区的估计数是为了提供区域背景，并能够与沙特阿拉伯的国家趋势进行比较。结论：从1990年到2023年，沙特阿拉伯艾滋病毒感染者的结核病负担大幅下降，特别是药物敏感结核病，这表明结核病控制和艾滋病毒管理取得了进展。耐药形式（耐多药结核病和广泛耐药结核病）表现出复杂的趋势，早期增加，随后稳定或逐渐减少绝对负担。

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来源期刊

Infectious Diseases and Therapy Medicine-Microbiology (medical)

CiteScore

8.60

自引率

1.90%

发文量

136

审稿时长

6 weeks

期刊介绍： Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.