Comparison of HIV/AIDS death estimates between GBD 2019 and WHO Mortality Database in 2019

Xuemei Wei¹Fang Qin²Juan Li¹Ya Huang¹Shaopeng Lu¹Junjie Huang¹Lu Wang¹Jie Li^1*Yukai Zhang^3*Xiaoxiang Yang^1*

• ¹Department of Infectious Diseases in Children, Maternity and Child Health Care of Guangxi Zhuang Autonomous Region, Nanning, China
• ²The People's Hospital of Chongzuo, Chongzuo, China
• ³Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, China

Background: HIV/AIDS death estimates serve as a crucial indicator for monitoring the status of the epidemic and the progress of intervention projects. The Global Burden of Disease (GBD) 2019 and the World Health Organization (WHO) Mortality Database offer open-access statistics on a global scale. This study compared HIV/AIDS death estimates between these two databases and explored potential sources of discrepancy. Methods: HIV/AIDS death counts and mortality rates (per 100,000 population) for 2019 were extracted from both databases and categorized by age, sex, and country. Absolute and standardized differences between GBD and WHO estimates were analyzed across demographic groups and countries. Spearman correlation coefficients and regression plots were used to assess consistency and visualize associations. Results: Among 78 countries with overlapping data, GBD estimated 108,668 HIV/AIDS deaths, while WHO reported 48,754, yielding a difference of 59,914 deaths (76.1% of the mean estimate). Despite overall strong correlations (r > 0.80, P < 0.05), notable discrepancies were observed in males, the 15–54 age group, and several countries, including Thailand (23,563), Brazil (6,063), the Philippines (4,658), Ukraine (4,238), Peru (2,617), and the United States (2,325). Conclusions: Substantial differences in HIV/AIDS death estimates persist in a few countries, likely due to variations in vital registration data quality, ICD coding practices, and estimation methodologies between databases. These findings highlight the need to strengthen mortality data systems and improve methodological transparency to enhance global HIV/AIDS mortality surveillance.