{
  "abstract": "Background: Tuberculosis (TB) and human immunodeficiency virus (HIV) remain global health threats. Extensively drug-resistant TB with HIV co-infection is associated with substantial mortality worldwide. This study aimed to estimate the global burden and temporal trends of extensively drug-resistant tuberculosis and human immunodeficiency virus co-infection (HIV/XDR-TB) from 1990 to 2021.\n\nMethods: We used the Global Burden of Diseases Study 2021 data to estimate the global burden of HIV/XDR-TB from 1990 to 2021. We employed a Disease Modeling-Meta-Regression model to estimate incidence, prevalence, mortality, and disability-adjusted life years. Mortality was calculated using population attributable fraction methods, accounting for HIV/XDR-TB overlap. Results were stratified by Socio-demographic Index (SDI) and reported with 95% uncertainty intervals (UIs).\n\nResults: In 2021, global HIV/XDR-TB incidence was 1,606.42 cases (95% UI, 1,163.94–2,182.83), with an age-standardized incidence rate of 1.94 per 10 million and a −15.59% change (95% UI, −36.38 to +10.26) since 2010. Mortality estimates indicated 840 deaths (95% UI, 385.44–1,491.72) in 2021, with an age-standardized death rate of 1.01 per 10 million (95% UI, 0.47–1.80), representing a 35.85% decline from 2010 (95% UI, −50.45% to −17.75%). The burden was highest among those aged 35–39 and consistently higher in males. Regionally, Eastern Europe and Southern Sub-Saharan Africa showed the highest burden, while Oceania had the greatest increase. Substantial heterogeneity was observed across regions and SDI levels.\n\nConclusion: Despite declines in HIV/XDR-TB burden, significant regional and demographic disparities persist, highlighting the need for targeted public health strategies in high-burden regions.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea .",
    "Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, Korea .",
    "Yonsei University College of Medicine, Seoul, Korea .",
    "Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA .",
    "KLNIK, Wilmslow, UK .",
    "Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea .",
    "Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea .",
    "Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea .",
    "Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea .",
    "Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK .",
    "Department of Public Health, Faculty of Medicine, Biruni University, Istanbul, Turkey ."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Eun Hye Lee",
      "orcid": "0000-0003-2570-3442"
    },
    {
      "affs": [
        2
      ],
      "name": "Yun Seo Kim",
      "orcid": "0000-0002-2883-7457"
    },
    {
      "affs": [
        3
      ],
      "name": "Min Seo Kim",
      "orcid": "0000-0003-2115-7835"
    },
    {
      "affs": [
        4
      ],
      "name": "Roshan Ravindran",
      "orcid": "0000-0001-9912-0018"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Dong Keon Yon",
      "orcid": "0000-0003-1628-9948"
    },
    {
      "affs": [
        7
      ],
      "name": "Young Ae Kang",
      "orcid": "0000-0002-7783-5271"
    },
    {
      "affs": [
        1,
        8
      ],
      "name": "Jae Il Shin",
      "orcid": "0000-0003-2326-1820"
    },
    {
      "affs": [
        9,
        10
      ],
      "name": "Lee Smith",
      "orcid": "0000-0002-5340-9833"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/aq661v54hxay9.bib",
  "cited_by": 0,
  "doi": "10.3346/jkms.2026.41.e302",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13730649/?tool=EBI",
  "id": "aq661v54hxay9",
  "issns": [
    "1598-6357",
    "1011-8934"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13730649",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Medicine General & Health Policy"
    ],
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2725|Tuberculosis Research and Epidemiology"
    ]
  ],
  "openalex": "W7196940832",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13730649/pdf/?tool=EBI",
  "pmcid": "PMC13730649",
  "pmid": "42978138",
  "published": "2026-08-06",
  "publisher": "Korean Academy of Medical Sciences",
  "ris": "https://research.draconitic.com/paper/aq661v54hxay9.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:47Z",
      "native_id": "PMC:PMC13730649",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13730649"
    },
    {
      "first_seen": "2026-11-07T12:23:09Z",
      "native_id": "PMC13730649",
      "source": "pmc",
      "url": "https://doi.org/10.3346/jkms.2026.41.e302"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Tuberculosis Research and Epidemiology",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Global Trends and Burden of HIV Coinfection With Extensively Drug-Resistant Tuberculosis From 1990 to 2021: The Global Burden of Disease Study 2021",
  "title_text": "Global Trends and Burden of HIV Coinfection With Extensively Drug-Resistant Tuberculosis From 1990 to 2021: The Global Burden of Disease Study 2021",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:23:09Z",
  "url": "https://research.draconitic.com/paper/aq661v54hxay9",
  "venue": "Journal of Korean medical science",
  "versions": []
}