https://doi.org/10.4081/monaldi.2024.2899
Prevalence of extrapulmonary tuberculosis among people living with HIV/AIDS in Southeast Asia: a systematic review and meta-analysis
Submitted: January 6, 2024
Accepted: April 30, 2024
Published: July 23, 2024
Accepted: April 30, 2024
Abstract Views: 488
PDF_EARLY VIEW: 179
SUPPLEMENTARY MATERIAL: 17
SUPPLEMENTARY MATERIAL: 17
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The dual burden of human immunodeficiency virus (HIV) and tuberculosis (TB) impacts people living with HIV (PLHIV) coinfected with TB. Although some primary studies have been reported on the burden of extrapulmonary TB (EPTB) among PLHIV in Southeast Asia (SEA), there is no systematic review or meta-analysis that attempts to summarize the available literature. Therefore, this review aims to summarize the prevalence of EPTB/HIV co-infection in SEA using meta-analysis based on a systematic review of published articles and gray literature. A comprehensive 3-stage methodology was adopted to conduct a thorough literature search, encompassing both published and gray literature. Data sources such as MEDLINE and Web of Science were searched for articles reporting data from SEA between 2010 and 2022. Findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and were sourced using a predefined search strategy from different databases. The Joanna Briggs Institute prevalence studies checklist was employed for critical appraisal. The meta-analysis of proportions was carried out using the "metaprop" function in R software (version 4.3.1) to generate pooled estimates. Effects were summarized using random-effects models, and sources of heterogeneity were explored through I2, utilizing subgroup and sensitivity analyses. Publication bias was assessed using funnel plots and pertinent statistical tests, including Egger's regression analysis. A total of 474 studies were initially identified in our search. After the removal of duplicates and a meticulous screening process of titles and abstracts, along with the application of exclusion criteria, 22 studies comprising 34,740 PLHIV were included in the final meta-analysis. The summary effect or pooled proportion estimate of EPTB among PLHIV was found to be 18% [95% confidence interval (CI): 15,22; heterogeneity: τ2=0.0056; degrees of freedom=21, p<0.001; I2=99%]. Our study showed that there was a diverse range of prevalence of EPTB among PLHIV in the SEA region, which ranged from 5% (95% CI: 4.0-7.0) in South Korea to 48% (95% CI: 41.0-55.0) in Thailand. Our systematic review and meta-analysis indicate a notably higher prevalence of EPTB among PLHIV. Early diagnosis of EPTB is crucial to mitigating associated morbidity and mortality. Therefore, a thorough medical history and comprehensive physical examination are imperative in assessing PLHIV, aiming to promptly identify and rule out EPTB. After a diligent evaluation, appropriate diagnostic measures and tailored management strategies should be promptly instituted.
Rodriguez-takeuchi SY, Renjifo ME, Medina FJ. Extrapulmonary tuberculosis : pathophysiology and imaging findings. Radiographics 2019;39:2023-37.
DOI: https://doi.org/10.1148/rg.2019190109
World Health Organization. WHO consolidated guidelines on tuberculosis. Module 3: diagnosis - rapid diagnostics for tuberculosis detection, 2021 update. Available from: https://iris.who.int/bitstream/handle/10665/342331/9789240029415-eng.pdf?sequence=1.
Bagcchi S. WHO’s global tuberculosis report 2022. Lancet Microbe 2023;4:e20.
DOI: https://doi.org/10.1016/S2666-5247(22)00359-7
World Health Organization. Global tuberculosis report 2020. Available from: https://iris.who.int/bitstream/handle/10665/336069/9789240013131-eng.pdf?sequence=1.
World Health Organization. Improving the diagnosis and treatment of smear-negative pulmonary and extrapulmonary tuberculosis among adults and adolescents: recommendations for HIV-prevalent and resource-constrained settings. 2007. Available from:https://apps.who.int/iris/bitstream/handle/10665/69463/WHO_HTM_TB_2007.379_eng.pdf?sequence=1&.
World Health Organization. WHO policy on collaborative TB / HIV activities. Guidelines for national programmes and other stakeholders. 2012. Available from: https://www.ncbi.nlm.nih.gov/books/NBK131887/.
Barthwal MS, Rajan KE, Deoskar RB, Sharma SK. Extrapulmonary tuberculosis in human. Med J Armed Forces India 2004;61:340-1.
DOI: https://doi.org/10.1016/S0377-1237(05)80059-0
Kumar P, Sharma N, Sharma N, Patnaik S. Clinical profile of tuberculosis in patients with HIV Infection/AIDS. Indian J Chest Dis Allied Sci 2002;44:159-63.
Kumarasamy N, Solomon S, Flanigan TP, et al. Natural history of human immunodeficiency virus disease in southern India. Clin Infect Dis 2003;36:79-85.
DOI: https://doi.org/10.1086/344756
Ghiya R, Naik E, Casanas B, et al. Clinico-epidemiological pro fi le of HIV/TB coinfected patients in Vadodara, Gujarat. Indian J Sex Transm Dis AIDS 2009;30:10-5.
DOI: https://doi.org/10.4103/0253-7184.55472
Mehta A, Kumar V, Vithalani K, Patel K. Clinico-epidemiological profile of HIV patients with respiratory infections and tubeculosis in western India. J Clin Diagnostic Res 2011;5:206-9.
Sharma SK, Soneja M, Prasad KT, Ranjan S. Clinical profile & predictors of poor outcome of adult HIV- tuberculosis patients in a tertiary care centre in north India. Indian J Med Res 2014;139:154-60.
Kingkaew N, Sangtong B, Amnuaiphon W, et al. HIV-associated extrapulmonary tuberculosis in Thailand : epidemiology and risk factors for death. Int J Infect Dis 2009;13:722-9.
DOI: https://doi.org/10.1016/j.ijid.2008.11.013
Mohammed H, Assefa N, Mengistie B. Prevalence of extrapulmonary tuberculosis among people living with HIV/AIDS in sub-Saharan Africa: a systemic review and meta-analysis. HIV/AIDS (Auckl) 2018;10:225-37.
DOI: https://doi.org/10.2147/HIV.S176587
Page MJ, Mckenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement : an updated guideline for reporting systematic reviews systematic reviews and meta-analyses. BMJ 2021;372:n71.
Munn Z, Moola S, Lisy K, et al. Chapter 5: systematic reviews of prevalence and incidence. 2020. Available from: https://jbi.global/sites/default/files/2020-08/Checklist_for_Analytical_Cross_Sectional_Studies.pdf.
DOI: https://doi.org/10.46658/JBIRM-17-05
Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557-60.
DOI: https://doi.org/10.1136/bmj.327.7414.557
Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple , graphical test. BMJ 1997;315:629-34.
DOI: https://doi.org/10.1136/bmj.315.7109.629
Bishnu S, Bandyopadhyay D, Samui S, et al. Assessment of clinico-immunological profile of newly diagnosed HIV patients presenting to a teaching hospital of eastern India. Inidan J Med Res 2014;139:903-12.
Parchure R, Kulkarni V, Gangakhedkar, R Swaminathan S. Treatment outcomes of daily anti-tuberculosis treatment in HIV-infected patients seeking care at a private clinic in India. Int J Tuberc Lung Dis 2016;20:1348-53.
DOI: https://doi.org/10.5588/ijtld.16.0098
Poudel B, Dhungana G. Scenario of HIV/AIDS patients in a government hospital of Nepal. J Nepal Heal Res Counc 2010;8:103-6.
Phyo K, Oo M, Harries AD, et al. High prevalence and incidence of tuberculosis in people living with the HIV in Mandalay, Myanmar, 2011-2017. Int J Tuberc Lung Dis 2019;23:349-57.
DOI: https://doi.org/10.5588/ijtld.18.0436
Kim YJ, Woo JH, Kim MJ, al. Opportunistic diseases among HIV-infected patients: a multicenter-nationwide Korean HIV/AIDS cohort study, 2006 to 2013. Korean J Intern Med 2016;31:953-60.
DOI: https://doi.org/10.3904/kjim.2014.322
Karmakar S, Sharma SK, Vashishtha R, et al. Clinical characteristics of tuberculosis-associated immune reconstitution inflammatory syndrome in north Indian population of HIV/AIDS patients receiving HAART. Clin Dev Immunol 2011;2011:239021.
DOI: https://doi.org/10.1155/2011/239021
Shastri S, Naik B, Shet A, et al. TB treatment outcomes among TB-HIV co-infections in Karnataka, India: how do these compare with non-HIV tuberculosis outcomes in the province?. BMC Public Health 2013;13:838.
DOI: https://doi.org/10.1186/1471-2458-13-838
Songkhla MN, Tantipong H, Tongsai S, Angkasekwinai N. Lateral flow urine lipoarabinomannan assay for diagnosis of active tuberculosis in adults with human immunodeficiency virus infection: a prospective cohort study. Open Forum Infect Dis 2019;6:ofz132.
DOI: https://doi.org/10.1093/ofid/ofz132
Spalgais S, Agarwal U, Sarin R, et al. Role of routine abdominal ultrasonography in intensified tuberculosis case finding algorithms at HIV clinics in high TB burden settings. BMC Infect Dis 2017;17:351.
DOI: https://doi.org/10.1186/s12879-017-2433-6
Srirangaraj S, Venkatesha D. Opportunistic infections in relation to antiretroviral status among AIDS patients from south India. Indian J Med Microbiol 2011;29:395-400.
DOI: https://doi.org/10.4103/0255-0857.90175
Weber SF, Saravu K, Heller T, et al. Point-of-care ultrasound for extrapulmonary tuberculosis in india : a prospective cohort study in HIV-positive and HIV-negative presumptive tuberculosis patients. Am J Trop Med Hyg 2018;98:266-73.
DOI: https://doi.org/10.4269/ajtmh.17-0486
Das I, Kargupta A, Roy K, et al. Occurrence and outcome of opportunistic infections among haart experienced patients in a tertiary care hospital of kolkata. J Evol Med Dent Sci 2018;7:24-8.
DOI: https://doi.org/10.14260/jemds/2018/7
Witaningrum AM, Khairunisa SQ, Yunifiar MQ, et al. Opportunistic infection of HIV/AIDS patients in West Papua. IOP Conf Ser Earth Environ Sci 2018;125:012062.
DOI: https://doi.org/10.1088/1755-1315/125/1/012062
Khanal V, Jha N, Karki P, Paudel I. Opportunistic infections and clinical profile of HIV/AIDS patients: a study from eastern region of Nepal. Nepal Med Coll J 2014;16:194-7.
Pal A, Das A. Joint Modeling of HIV and tuberculosis through copula-based bivariate binary model. Stat Appl 2021;19:139-46.
Hiregoudar V, Raghavendra B, Karinagannavar A, et al. Proportion and determinants of tuberculosis among human immunodeficiency virus ‑ positive patients attending the antiretroviral therapy center attached to a Medical College in South India. J Fam Community Med 2016;23:88-93.
DOI: https://doi.org/10.4103/2230-8229.181009
Tan H, Yong Y, Lim S, et al. Tuberculosis (TB)-associated immune reconstitution inflammatory syndrome in TB-HIV co-infected patients in Malaysia: prevalence, risk factors, and treatment outcomes. Sex Health 2014;11:532-9.
DOI: https://doi.org/10.1071/SH14093
Kamath R, Sharma V, Pattanshetty S, et al. TB coinfection: clinico-epidemiological determinants at an antiretroviral therapy center in Southern India. Lung India 2013;30:302-6.
DOI: https://doi.org/10.4103/0970-2113.120605
Kapadiya DJ, Dave PV, Vadera B, et al. Assessment of tuberculosis prevalence in newly diagnosed human immunodeficiency virus ‑ infected adults attending care and treatment center in Gujarat , India. Indian J Community Med 2018;43:185-9.
DOI: https://doi.org/10.4103/ijcm.IJCM_291_17
Lee C, Hwang J, Oh D, et al. The burden and characteristics of tuberculosis/human immunodeficiency virus (TB/HIV ) in South Korea: a study from a population database and a survey. BMC Infect Dis 2010;10:66.
DOI: https://doi.org/10.1186/1471-2334-10-66
Matin N, Shahrin L, Pervez MM, et al. Clinical profile of HIV/AIDS-infected patients admitted to a new specialist unit in Dhaka, Bangladesh — a low-prevalence country for HIV. J Heal Popul Nutr 2011;29:14-9.
DOI: https://doi.org/10.3329/jhpn.v29i1.7562
World Health Organization. Ending TB in the south-east Asia region: regional strategic plan 2016-2020. 2016. Available from: https://iris.who.int/bitstream/handle/10665/205065/Ending%20TB%20in%20the%20SEAR%20reduced.pdf?sequence=1&isAllowed=y.
Bruchfeld J, Correia-Neves M, Kallenius G. Tuberculosis and HIV coinfection. Cold Spring Harb Perspect Med 2015;5:a017871.
DOI: https://doi.org/10.1101/cshperspect.a017871
National Aids Control Organisation. National guidelines for HIV care and treatment 2021. Available from: https://naco.gov.in/sites/default/files/National_Guidelines_for_HIV_Care_and_Treatment_2021.pdf.
World Health Organization. Tuberculosis. 2023 Available from: https://www.who.int/news-room/fact-sheets/detail/tuberculosis. Accessed on: 22/12/2023.
Golden MP, Raphael S, Haven N. Extrapulmonary tuberculosis: an overview. Am Fam Physician 2005;72:1761-8.
Chauhan A, Parmar M, Dash GC, et al. The prevalence of tuberculosis infection in India: A systematic review and meta-analysis. Indian J Med Res 2023;157:135-51.
DOI: https://doi.org/10.4103/ijmr.ijmr_382_23
Benchimol EI, Smeeth L, Guttmann A, et al. The REporting of studies conducted using observational routinely-collected health data (RECORD) statement. PLoS Med 2015;12:e1001885.
DOI: https://doi.org/10.1371/journal.pmed.1001885
How to Cite
Harshana, Amit, Mohit Goyal, Augustine Chako, and Raman Mahajan. 2024. “Prevalence of Extrapulmonary Tuberculosis Among People Living With HIV AIDS in Southeast Asia: A Systematic Review and Meta-Analysis”. Monaldi Archives for Chest Disease, July. https://doi.org/10.4081/monaldi.2024.2899.
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Elio Gorga, Marta Scodro, Francesca Valentini, Renzo D'Ortona, Mariachiara Arisi, Edoardo Sciatti, Ivano Bonadei, Valentina Regazzoni, Enrico Vizzardi, Marco Metra, Piergiacomo Calzavara Pinton, Echocardiographic evaluation of diastolic dysfunction in young and healthy patients with psoriasis: A case-control study , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- S.M. Mirsaeidi, P. Tabarsi, M.O. Edrissian, M. Amiri, P. Farnia, S.D. Mansouri, M.R. Masjedi, A.A. Velayati, Primary multi-drug resistant tuberculosis presented as lymphadenitis in a patient without HIV infection , Monaldi Archives for Chest Disease: Vol. 61 No. 4 (2004): Pulmonary series
- S.M. Mirsaeidi, P. Tabarsi, A. Mardanloo, G. Ebrahimi, M. Amiri, P. Farnia, M. Sheikhleslami, V. Bakayev, F. Mohammadi, S.D. Mansouri, M.R. Masjedi, A.A. Velayati, Pulmonary Mycobacterium Simiae infection and HTLV1 infection: an incidental co-infection or a predisposing factor? , Monaldi Archives for Chest Disease: Vol. 65 No. 2 (2006): Pulmonary series
- Laura Casaretti, Stefania Paolillo, Roberto Formisano, Ada Bologna, Giacomo Mattiello, Sirio Conte, Laura Petraglia, Francesco Lo Iudice, Irma Fabiani, Anna Paola Cirillo, Alice Vitagliano, Francesco Gambardella, Giuseppe Luca della Ratta, Pasquale Perrone Filardi, Metabolic and cardiovascular effects of combined antiretroviral therapy in patients with HIV infection. Systematic review of literature , Monaldi Archives for Chest Disease: Vol. 76 No. 4 (2011): Cardiac series
- A.J. Lopes, T.T. Mafort, A. de Sá Ferreira, M.C. Santos de Castro, M. de Cássia Firmida, E. de Andrade Marques, Is the type of chronic pulmonary infection a determinant of lung function outcomes in adult patients with cystic fibrosis? , Monaldi Archives for Chest Disease: Vol. 77 No. 3-4 (2012): Pulmonary series
- Alessandra Schiavo, Francesca M. Stagnaro, Andrea Salzano, Alberto M. Marra, Emanuele Bobbio, Pietro Valente, Simona Grassi, Martina Miniero, Michele Arcopinto, Margherita Matarazzo, Raffaele Napoli, Antonio Cittadini, Pregabalin-induced first degree atrioventricular block in a young patient treated for pain from extrapulmonary tuberculosis , Monaldi Archives for Chest Disease: Vol. 87 No. 3 (2017)
- P.D.O. Davies, Risk factors for tuberculosis , Monaldi Archives for Chest Disease: Vol. 63 No. 1 (2005): Pulmonary series
- A.E. Erbaycu, Z. Taymaz, F. Tuksavul, A. Afrashi, S.Z. Güçlü, What happens when oral tuberculosis is not treated? , Monaldi Archives for Chest Disease: Vol. 67 No. 2 (2007): Pulmonary series
- A.A. Velayati, P. Farnia, M.R. Boloorsaze, M.F. Sheikholslami, S. Khalilzadeh, S.S. Hakeeme, M.R. Masjedi, Mycobacterium Bovis infection in children in the same family: transmission through inhalation , Monaldi Archives for Chest Disease: Vol. 67 No. 3 (2007): Pulmonary series
- J.P. Zellweger, Tobacco and tuberculosis , Monaldi Archives for Chest Disease: Vol. 69 No. 2 (2008): Pulmonary series
You may also start an advanced similarity search for this article.
