This study aims to investigate the relationship between HIV infection and multi-drug resistant tuberculosis (MDR-TB) among affected individuals in Zahedan, Iran. It will involve a detailed analysis of patient demographics, clinical characteristics, and treatment outcomes to enhance understanding of this co-infection. The findings may inform better treatment strategies and healthcare policies for managing these diseases in similar populations.

Inclusion Criteria:

• Adults (aged 18 years and older) diagnosed with both HIV and multi-drug-resistant tuberculosis (MDR-TB).
• Studies published in peer-reviewed journals.
• Studies that provide data on the co-occurrence of HIV and MDR-TB.
• Participants from diverse geographical regions to enhance generalizability.
• Studies with clear definitions of MDR-TB according to WHO guidelines.

Exclusion Criteria:

• Studies that focus solely on drug-susceptible tuberculosis without MDR-TB.
• Studies involving pediatric populations (under 18 years of age).
• Non-original research such as reviews, editorials, and commentaries.
• Studies lacking sufficient data on the co-occurrence of HIV and MDR-TB.
• Studies that do not adhere to ethical guidelines for human subjects or lack appropriate ethical approvals.

The study population consists of adult individuals (aged 18 years and older) diagnosed with both HIV infection and multi-drug-resistant tuberculosis (MDR-TB). This meta-analysis synthesizes data from various studies conducted across multiple countries, including Brazil, the USA, Canada, India, Ethiopia, and several others. The population includes a diverse cohort of patients, reflecting various demographic characteristics such as age, sex, and geographical location.

The studies included in this meta-analysis feature participants with confirmed diagnoses of HIV and MDR-TB, with a focus on understanding the co-infection dynamics, treatment outcomes, and associated health challenges. Data extraction from these studies provides insight into the prevalence and impact of MDR-TB among HIV-positive patients, highlighting the importance of tailored