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. 2024 Dec 10:6:1475498.
doi: 10.3389/frph.2024.1475498. eCollection 2024.

Global, regional, and national burden of HIV and tuberculosis and predictions by Bayesian age-period-cohort analysis: a systematic analysis for the global burden of disease study 2021

Xuebin Tian  1   2 , Chong Wang  3 , Zhihao Hao  4 , Jingjing Chen  5 , Nanping Wu  1   2
Affiliations

Global, regional, and national burden of HIV and tuberculosis and predictions by Bayesian age-period-cohort analysis: a systematic analysis for the global burden of disease study 2021

Xuebin Tian et al. Front Reprod Health. .

Abstract

Objective: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: Bayesian age-period-cohort; age-standardized rate; disability-adjusted life years; disease burden; human immunodeficiency virus and tuberculosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(a) Age-standardized DALY rates of HIV-DS-TB, (b) age-standardized DALY rates of HIV-MDR-TB, (c) age-standardized DALY rates of HIV-XDR-TB per 100,000 cases in 2021 by country. DALY, disability-adjusted life year; HIV-DS-TB, HIV/AIDS-drug-susceptible tuberculosis; HIV-MDR-TB, HIV/AIDS-multidrug-resistant tuberculosis without extensive drug resistance; HIV-XDR-TB, HIV-AIDS-extensively drug-resistant tuberculosis.
Figure 2
Figure 2
(a) Age-standardized incidence, prevalence, death, and DALY rate by global, high SDI, high-middle SDI, middle SDI, low-middle SDI, and low SDI in HIV-DS-TB from 1990 to 2021. (b) Age-standardized incidence, prevalence, death, and DALY rate by global, high SDI, high-middle SDI, middle SDI, low-middle SDI, and low SDI in HIV-MDR-TB from 1990 to 2021. (c) Age-standardized incidence, prevalence, deaths and DALY rate by global, high SDI, high-middle SDI, middle SDI, low-middle SDI, and low SDI in HIV-XDR-TB from 1990 to 2021. SDI, socio-demographic index.
Figure 3
Figure 3
(a) Age-standardized incidence rate, (b) age-standardized prevalence rate, (c) age-standardized deaths rate, and (d) age-standardized DALY rate of HIV-DS-TB, HIV-MDR-TB, and HIV-XDR-TB in 21 disease burden regions in 2021.
Figure 4
Figure 4
(a) Female and male age-standardized DALY rate by age in global in 2021. (b) Female and male age-standardized DALY rate by age in high SDI in 2021. (c) Female and male age-standardized DALY rate by age in high-middle SDI in 2021. (d) Female and male age-standardized DALY rate by age in middle SDI in 2021. (e) Female and male age-standardized DALY rate by age in Low-middle SDI in 2021. (f) Female and male age-standardized DALY rate by age in low SDI in 2021.
Figure 5
Figure 5
Risk factor analysis for (a) HIV-DS-TB, (b) HIV-MDR-TB and (c) HIV-XDR-TB in global and SDI regions in 2021.
Figure 6
Figure 6
Trends in age-standardized DALY rates from 2021 to 2035 for (a) HIV-DS-TB, (b) HIV-MDR-TB, and (c) HIV-XDR-TB predicted by Bayesian age–period–cohort (BAPC) models.
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