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

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

doi:10.1097/QAD.0000000000003886

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

AIDS. 2024 Mar 18. doi: 10.1097/QAD.0000000000003886. Online ahead of print.

Authors

Affiliations

¹ Medical School of Nantong University, Nantong, Jiangsu, PR China.
² Department of general surgery, Affiliated Hospital of Nantong University, Jiangsu, PR China.
³ Department of Orthopaedics, Traditional Chinese Medical Hospital of Nantong City, Nantong, Jiangsu, PR China.
⁴ School of Public Health, Nantong University, Nantong, Jiangsu, PR China.

PMID: 38499478
DOI: 10.1097/QAD.0000000000003886

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-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% 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 EPTB, 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.