Prevalence and risk factors of tuberculosis among people living with HIV/AIDS in China: a systematic review and meta-analysis

Abstract

Objective: To estimate the prevalence and risk factors associated with tuberculosis (TB) among people living with human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) in China.

Methods: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. After the literature was screened based on the inclusion and exclusion criteria, STATA^® version 17.0 software was used for the meta-analysis. The heterogeneity among study data was assessed using I² statistics. Subgroup analysis and meta-regressions were performed to further explore the source of heterogeneity.

Results: A total of 5241 studies were retrieved. Of these, 44 studies were found to be eligible. The pooled prevalence of HIV/TB co-infection was 6.0%. The risk factors for HIV/TB co-infection included a low CD4⁺ T cell count, smoking, intravenous drug use and several other sociodemographic and clinical factors. Bacillus Calmette-Guérin (BCG) vaccination history was a protective factor.

Conclusion: A high prevalence of TB was observed among people living with HIV/AIDS in China. Low CD4⁺ T cell count, smoking, and intravenous drug use were the primary risk factors for HIV/TB co-infection, whereas BCG vaccination history was a protective factor. Checking for TB should be prioritized in HIV screening and healthcare access.

Systematic review registration: Registered on PROSPERO, Identifier: CRD42022297754.

Keywords: HIV/AIDS; Meta-analysis; Prevalence; Risk factors; Tuberculosis.