HIV-tuberculosis co-infection in Liangshan, a resource-limited region of Southwest China: trends and implications in the context of integrated prevention, 2019-2024.

Authors

Xuefei Bai, Ju Wang, Gang Yu, Jinhong Shi, Sisi Fan, Ruobing Wang, Yubing Wang, Xiaoying Feng, Rong Pei, Rujun Liao

Published in

Infectious diseases of poverty. Volume 15. Issue 1. Sep 04, 2026. Epub Sep 04, 2026.

Abstract

Tuberculosis (TB) and HIV co-infection remains a major public health challenge in resource-limited settings. Liangshan Yi Autonomous Prefecture in Southwest China bears a dual high burden of HIV and TB. This study aimed to analyze the epidemiological trends of HIV-TB co-infection in Liangshan from 2019 to 2024 and to inform integrated prevention strategies.
A retrospective analysis was conducted on 3367 HIV-TB co-infected cases extracted from the National HIV/AIDS and TB surveillance systems. Records were linked via unique identifiers. Descriptive statistics and chi-square tests for trend assessed incidence trends, demographics, transmission routes, treatment outcomes, and drug resistance.
From 2019 to 2024, HIV-TB incidence declined from 12.26 to 8.76 per 100,000 (χ²_trend = 40.459, P < 0.001), driven by high-burden counties and populations under 45 years (all P < 0.001). Patients were predominantly young males (61.10%) and farmers (92.37%). The main HIV transmission routes were heterosexual contact (48.29%) and injection drug use (41.31%), with marked sex and age disparities: injection drug use predominated in males (50.92%) and those aged 30 - < 45 years (50.32%), while heterosexual transmission prevailed in females (77.07%) and older adults (≥ 60 years, 87.62%). Treatment success rate was 81.76%, significantly lower in the elderly (69.52%, P < 0.05). Any drug resistance (3.30%) increased from 1.54% to 3.10% (χ²_trend = 8.481, P _trend = 0.004).
During the implementation of integrated strategies, HIV-TB incidence showed a declining trend, particularly in high-burden areas and younger populations. Persistent challenges-stagnant incidence and poor outcomes in the elderly, high loss to follow-up (10.87%), rising drug resistance-require targeted interventions: leveraging the Yi "clan" (Jiazhi) system, strengthening active screening and nutritional support for older adults, optimizing drug resistance surveillance, and integrating digital health tools.

PMID:
42698105
Bibliographic data and abstract were imported from PubMed on 05 Sep 2026.

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