Abstract: Objective To analyze the survival status and associated factors among patients aged ≥50 years with human immunodeficiency virus (HIV) and tuberculosis (TB) coinfection (HIV-TB coinfection) in Baise City from 1997 to 2023. Methods Data of patients with HIV infection in Baise from 1997 to 2023 were extracted from the Basic Information System for AIDS Prevention and Control within the Chinese Information System for Disease Control and Prevention. These data were matched with reported pulmonary tuberculosis cases from the Comprehensive Information System for Tuberculosis Prevention and Control to identify HIV-TB coinfected individuals aged ≥50 years. The life table method was utilized to calculate survival rates, the Kaplan-Meier method was employed to plot survival curves, and the Cox proportional hazards regression model was used to analyze the factors influencing the survival time of this patient cohort. Results A total of 445 cases of HIV-TB coinfection in individuals aged ≥50 years were identified in Baise City from 1997 to 2023. Among these, 199 deaths were attributed to AIDS-related illnesses, resulting in a case fatality rate of 44.72%. The median age at diagnosis of HIV-TB coinfection was 60 (Interquartile Range:54, 67) years, and the median survival time was 78 months (95% CI:61.687-93.423). The cumulative survival rates for years 1 through 6 were 78.70%, 70.62%, 62.51%, 56.97%, 54.44%, and 52.27%, respectively. Multivariate Cox proportional hazards model analysis indicated a higher risk of mortality among HIV-TB coinfection patients who were male (HR=1.545, 95% CI:1.019-2.345), aged ≥70 years (HR=1.543, 95% CI:1.023-2.322), had an educational level below junior high school (HR=1.448, 95% CI:1.068-1.964), and had not received antiretroviral therapy (HR=5.627, 95% CI:4.150-7.629). Conclusion Middle-aged and elderly individuals with HIV-TB coinfection exhibit short survival times, particularly those who are male, aged ≥70 years, have a low educational level, or have not received antiretroviral therapy. It is imperative to implement targeted health education campaigns, enhance health monitoring and management for the middle-aged and elderly population to ensure early detection, diagnosis, and treatment. These measures are crucial for reducing the mortality risk and extending the survival duration of older patients with HIV-TB coinfection.

Key words: HIV-TB coinfection, Middle-aged and elderly, Survival analysis, Influencing factors