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The World Health Organization (WHO<\/jats:styled-content>) recommends HIV<\/jats:styled-content> testing for all individuals with TB<\/jats:styled-content> symptoms, but implementation has been suboptimal. We conducted a systematic literature review and meta\u2010analyses to estimate HIV<\/jats:styled-content> and TB<\/jats:styled-content> prevalence, and short\u2010term (two to six\u00a0months) mortality, among adults with TB<\/jats:styled-content> symptoms at community\u2010 and facility level.<\/jats:p><\/jats:sec>Methods<\/jats:title>We searched Embase, Global Health and MEDLINE<\/jats:styled-content> databases, and reviewed conference abstracts for studies reporting simultaneous HIV<\/jats:styled-content> and TB<\/jats:styled-content> screening of adults in LMIC<\/jats:styled-content>s published between January 2003 and December 2017. Meta\u2010analyses were performed to estimate prevalence of HIV<\/jats:styled-content>, undiagnosed TB<\/jats:styled-content> and mortality risk at different health system levels.<\/jats:p><\/jats:sec>Results<\/jats:title>Sixty\u2010two studies including 260,792 symptomatic adults were identified, mostly from Africa and Asia. Median HIV<\/jats:styled-content> prevalence was 19.2% (IQR<\/jats:styled-content>: 8.3% to 40.4%) at community level, 55.7% (IQR<\/jats:styled-content>: 20.9% to 71.2%) at primary care level and 80.7% (IQR<\/jats:styled-content>: 73.8% to 84.6%) at hospital level. Median TB<\/jats:styled-content> prevalence was 6.9% (IQR<\/jats:styled-content>: 3.3% to 8.4%) at community, 20.5% (IQR<\/jats:styled-content>: 11.7% to 46.4%) at primary care and 36.4% (IQR<\/jats:styled-content>: 22.9% to 40.9%) at hospital level. Median short\u2010term mortality was 22.6% (IQR<\/jats:styled-content>: 15.6% to 27.7%) among inpatients, 3.1% (IQR<\/jats:styled-content>: 1.2% to 4.2%) at primary care and 1.6% (95% CI<\/jats:styled-content>: 0.45 to 4.13, n\u00a0=\u00a01 study) at community level.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Adults with TB<\/jats:styled-content> symptoms have extremely high prevalence of HIV<\/jats:styled-content> infection, even when identified through community surveys. TB<\/jats:styled-content> prevalence and mortality increased substantially at primary care and inpatient level respectively. Strategies to expand symptom\u2010based TB<\/jats:styled-content> screening combined with HIV<\/jats:styled-content> and TB<\/jats:styled-content> testing for all symptomatic individuals should be of the highest priority for both disease programmes in LMIC<\/jats:styled-content>s with generalized HIV<\/jats:styled-content> epidemics. Interventions to reduce short\u2010term mortality are urgently needed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25162","type":"journal-article","created":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T11:52:20Z","timestamp":1533124340000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["High HIV<\/scp> and active tuberculosis prevalence and increased mortality risk in adults with symptoms of TB<\/scp>: a systematic review and meta\u2010analyses"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3100-5512","authenticated-orcid":false,"given":"Marriott","family":"Nliwasa","sequence":"first","affiliation":[{"name":"Helse Nord Tuberculosis Initiative Department of Pathology College of Medicine Blantyre Malawi"},{"name":"Malawi\u2010Liverpool\u2010Welcome Trust Clinical Research Programme Blantyre Malawi"},{"name":"Clinical Research Department London School of Hygiene & Tropical 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London School of Hygiene & Tropical Medicine (LSHTM) London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon \u00d8","family":"Odland","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Faculty of Health Sciences UiT The Arctic University of Norway Troms\u00f8 Norway"},{"name":"School of Public Health University of Pretoria Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Flach","sequence":"additional","affiliation":[{"name":"Department of Primary Care & Public Health Sciences King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth L.","family":"Corbett","sequence":"additional","affiliation":[{"name":"Helse Nord Tuberculosis Initiative Department of Pathology College of Medicine Blantyre Malawi"},{"name":"Malawi\u2010Liverpool\u2010Welcome Trust Clinical Research Programme Blantyre Malawi"},{"name":"Clinical Research Department 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