Prevalence of hepatitis C virus and human immunodeficiency virus in a group of patients newly diagnosed with active tuberculosis in Porto Alegre, Southern Brazil

Abstract

BACKGROUND Porto Alegre is the Brazilian state capital with second highest incidence of tuberculosis (TB) and the highest proportion of people infected with human immunodeficiency virus (HIV) among patients with TB. Hepatitis C virus (HCV) infection increases the risk of anti-TB drug-induced hepatotoxicity, which may result in discontinuation of the therapy.OBJECTIVES The aim of this study was (i) to estimate prevalence of HCV and HIV in a group of patients newly diagnosed with active TB in a public reference hospital in Porto Alegre and (ii) to compare demographic, behavioural, and clinical characteristics of patients in relation to their HCV infection status.METHODS One hundred and thirty-eight patients with TB were tested for anti-HCV antibody, HCV RNA, and anti-HIV1/2 antibody markers. HCV RNA from real-time polymerase chain reaction (PCR)-positive samples was submitted to reverse transcription and PCR amplification. The 5′ non-coding region of the HCV genome was sequenced, and genotypes of HCV isolates were determined.FINDINGS Anti-HCV antibody, HCV RNA, and anti-HIV antibodies were detected in 27 [20%; 95% confidence interval (CI), 13-26%], 17 (12%; 95% CI, 7-18%), and 34 (25%; 95% CI, 17-32%) patients, respectively. HCV isolates belonged to genotypes 1 (n = 12) and 3 (n = 4). Some characteristics were significantly more frequent in patients infected with HCV. Among them, non-white individuals, alcoholics, users of illicit drugs, imprisoned individuals, and those with history of previous TB episode were more commonly infected with HCV (p < 0.05).MAIN CONCLUSIONS HCV screening, including detection of anti-HCV antibody and HCV RNA, will be important to improving the management of co-infected patients, given their increased risk of developing TB treatment-related hepatotoxicity.

Hepatitis C: evaluation of outcomes and georeferencing of cases in Santa Cruz do Sul, Brazil, between 2002 and 2015. A cross-sectional study

“…13,14 Similar results were observed in our study. The diagnosis of hepatitis C is more frequent in adulthood and among the elderly, given that it is a silent and chronic disease, and because these individuals may have undergone some type of surgery with inadequately sterilized instruments and unsafe blood transfusions before the year 1993, when there was no screening for hepatitis C in blood banks yet.…”

“…14,15 Regarding sex, the hepatitis C cases were predominant among male individuals (67%), thus corroborating other studies. 13,16 In Brazil, 106,637 HCV cases occurred among males between 1999 and 2015, representing 58.5% of all cases. 1 The higher prevalence of hepatitis C virus infection among males can be explained by their exposure to risk factors, or by the fact that the diagnosis of HCV is made when men are blood donation volunteers.…”

Screening for HBV, HCV, HIV and syphilis infections among bacteriologically confirmed tuberculosis prisoners: An urgent action required

“…Tuberculosis is still the most common opportunistic infection worldwide [4], and it has been endemic especially inside Brazilians prisons [23]. Anti-HCV prevalence rates are generally higher among patients with TB than in the general population [24, 25, 26]. In 2014, it was estimated that there were around 10.2 million prisoners worldwide, 2.8% had active TB, 15.1% had HCV infection, 3.8% had HIV and 4.8% had chronic HBV [3].…”

“…Participants with evidence of HCV, HBV and syphilis exposure were significantly more likely to be aged > 35 years. Age is considered to be a cumulative risk factor for syphilis, HCV and HBV infections through blood, blood products, and sexual routes [28, 24, 37, 38].…”

Hepatitis C disease burden and strategies for elimination by 2030 in Brazil. A mathematical modeling approach

“…A viremic rate of 60.7% was calculated through a weighted average of five studies in Brazil. 12 , 13 , 14 , 15 …”