Association between tuberculosis, HIV infection, and diabetes mellitus: should we integrate screening and care? A systematic review

Abstract

Tuberculosis (TB) and HIV/AIDS are among the leading infectious diseases worldwide, while diabetes mellitus (DM) is a major chronic endocrine and metabolic disorder. Together, these conditions contribute substantially to the global burden of disease and mortality and are increasingly recognized as interconnected comorbidities. The combination of these three diseases can worsen patients' health conditions, increase mortality risk, and complicate treatment, which is why this study aims to summarize the relationship between HIV, TB, and DM. To achieve this, a systematic literature search was conducted across four databases PubMed, Wiley, ScienceDirect, and Scopus focusing on English articles from the last 5 years, where researchers independently established eligibility criteria, conducted a comprehensive search, meticulously extracted data, and determined the risk of bias. The findings indicate a significant relationship between these conditions, as the six articles analyzed showed that the prevalence of DM in TB patients ranged from 7.6% to 22.6%, while the prevalence of HIV in TB patients reached up to 38.57%. Specifically, DM increases the risk of developing active TB and is associated with unfavorable treatment outcomes, whereas HIV progressively impairs cell-mediated immunity through CD4+ T-cell depletion, substantially increasing the risk of progression from latent TB infection to active disease. Ultimately, there is a complex relationship between HIV, TB, and DM that adversely affects patients' overall health, leading to the conclusion that integrated screening and management for these three diseases are essential to reduce mortality risk and improve treatment outcomes.

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