Efficacy and safety of systematic corticosteroids treatment among HIV-positive patients with tuberculosis: A systematic review and meta-analysis of randomized controlled trials

INTRODUCTION: The efficacy and safety of corticosteroids in patients with human immunodeficiency virus (HIV) and tuberculosis (TB) remain controversial. METHOD: PubMed, Embase, Web of Science, and the Cochrane Database were searched on September 19, 2024. The primary outcome was all-cause mortality, while secondary outcomes included serious adverse events. A random-effects model calculated risk ratios (RR) with 95% confidence intervals (CIs). RESULT: Seven RCTs involving 1,410 HIV-positive TB patients were included. Corticosteroid use was not significantly reduce all-cause mortality (RR = 0.91, 95% CI: 0.79–1.04, P = 0.17) and did not significantly increase serious adverse events (RR = 0.96, 95% CI: 0.82–1.13, P = 0.63). CONCLUSION: This meta-analysis of seven RCTs involving 1,410 HIV-positive TB patients found that corticosteroid treatment neither significantly reduced all-cause mortality nor increased serious adverse events. Further large-scale RCTs with extended follow-up are needed to explore potential benefits in subgroups, optimize treatment protocols, and inform clinical guidelines.

• Population(s)
  • General HIV+ population
• Co-infections
  • Tuberculosis