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


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.


Hu FH, Tang XL, Ge MW, Jia YJ, Zhang WQ, Tang W, Shen LT, Du W, Xia XP, Chen HL




  • Epidemiology and Determinants of Health
    • Epidemiology
  • Population(s)
    • Children or Youth (less than 18 years old)
    • General HIV+ population
  • Co-infections
    • Tuberculosis


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