Abstract
BACKGROUND: Hepatitis B (HB), tuberculosis (TB), HIV infection and AIDS (HIV/AIDS) are the major public health threats in China. The existing domestic research shows significant regional differences in the coinfection of HB, TB, and HIV/AIDS and mainly focused on two diseases. This study aims to analyse the coinfection of HB, TB, and HIV/AIDS patients in Beijing from 2016 to 2023. METHODS: We obtained data on cases diagnosed with HB, TB, or HIV/AIDS between 1 January 2016 and 31 December 2023 in Beijing from the National Notifiable Disease Reporting System (NNDRS). After removing duplicate cards with the same disease, we compared the demographic, temporal, and spatial characteristics between coinfections and mono-infections and among coinfections with different diagnostic sequences using chi-squared test. We also explored the risk factors for coinfection by multivariate logistic models. RESULTS: Overall, 104,141 cards from 103,595 cases in Beijing were included in this study. The number of cases infected with HIV/AIDS, HB, or TB alone was 20,884 (20.12%), 23,853 (23.03%), and 58,357 (56.33%), respectively. Furthermore, 47 cases (0.05%) were diagnosed with HIV/AIDS and HB, 153 (0.15%) with HB and TB, and 336 (0.32%) with HIV/AIDS and TB. And only five cases were diagnosed with all three diseases. 0.22% HB and 1.58% TB were coinfected among HIV/AIDS patients; 0.64% TB and 0.20% HIV/AIDS were coinfected in HB patients, and 0.26% HB and 0.57% HIV/AIDS in TB patients. Differences in demographic characteristics, residential areas, and diagnosis years were found between coinfected patients and those with a single disease. In contrast, almost no significant difference in characteristics and diagnostic time intervals was found among comorbidity patients with the same diseases but different diagnostic sequences. The multivariate logistic model shown that males were more susceptible to be coinfected (ORs ranged from 1.50 to 27.81). Compared with the cases aged 60 and above, younger TB patients were more likely to be coinfected with HIV/AIDS (OR = 2.76[95%CI:1.59-4.77], 5.36[3.16-9.07]and 2.75[1.62-4.65] for those aged 15-29, 30-44 and 45-59), while younger HB or HIV/AIDS patients were less likely to be coinfected with TB (OR = 0.37[0.18-0.73], 0.34[0.20-0.59], 0.63[0.40-0.98] for younger HB and OR = 0.27[0.15-0.48],0.46[0.26-0.81],0.59[0.33-1.03] for younger HIV/AIDS). Compared with TB patients in urban areas, suburban patients are less likely to be infected with HIV/AIDS (OR = 0.63[0.50-0.79] for inner suburbs and 0.33[0.16-0.72] for outer suburbs). Patients infected with TB or HIV/AIDS living in outer suburbs were more likely to be coinfected with HB (OR = 2.65[1.62-4.34] for TB and OR = 4.04[1.18-13.85] for HIV/AIDS). Patients coinfected with TB and HB had longer diagnostic intervals than those infected with HIV. CONCLUSIONS: The incidence of comorbidity of HB, TB, and HIV/AIDS was low and showed a declining trend in Beijing. Among various types of coinfections, HIV/AIDS coinfected with TB has the highest incidence. Males should be considered as the primary target population for preventing coinfections. In addition to promoting the development of information technology and integrating data from multiple sources, it is essential to conduct thematic investigations, enhance education among key populations, and intensify the tracking of close contacts of existing patients to prevent and control the spread of these diseases.