Characteristics and TB treatment outcomes in TB patients with viral hepatitis, New York City, 2000–2010

Bushnell, Greta A.; Stennis, Natalie; Drobnik, Ann; Proops, Douglas; Ahuja, Shama D.; Bornschlegel, Katherine; Fuld, Jennifer

doi:10.1017/s0950268814002970

Cited by 20 publications

(24 citation statements)

References 29 publications

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“…Similar findings have been reported in different studies [2,4,5,11,[17][18][19][20][21][22]. Hepatitis B virus carrier might be at a higher risk of contracting TB.…”

Section: Ethical Approvalsupporting

confidence: 91%

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Parallel and Overlapping Infection of Human Immunodeficiency Virus and Hepatitis B Virus Among Tuberculosis Patients Attending A Tuberculosis/Leprosy Referral Centre in Central Nigeria: A Cross-Sectional Study

Gri¹,

Oti²,

Ca³

2018

J Transl Gastroenterol Clin Hepatol

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Tuberculosis (TB) is a global health problem. Coinfection with Human Immunodeficiency Virus (HIV) and Hepatitis B virus (HBV) among TB patients has paved way for the resurgence of Mycobacterium tuberculosis infection as well as increased risk of hepatotoxicity during tuberculosis therapy. There is paucity of published data on HIV/HBV infection in TB patients in Nigeria. This was a baseline study carried out to determine coinfection of HIV and HBV in Tuberculosis confirmed patients attending a TB/Leprosy referral healthcare Centre in Central Nigeria. Blood samples were collected from 400 confirmed TB patients and their sociodemograph information were obtained using a structured questionnaire. Samples were analyzed for anti-HIV and HbsAg using Enzyme Linked Immunosorbent Assay (J. Mitra and Co. Pvt. Ltd, India and Shantha Biotechnics Ltd, India respectively). Data were analyzed using SSP version 2.80. P value ≤ 0.05 was considered statistically significant. Of the 400 patients, 68(17.0%) tested positive for HIV and 48(12.0%) for HBV while 6 (1.5%) had HIV/HBV coinfection. Gender, history of STI, history of HBV vaccine and educational status were associated risk factors for the viral infection. Age, history of blood transfusion and scarification mark did not show any statistically significant association to the viral infections. The prevalence rates of HIV and HBV recorded in this population is a cause for alarm. There is therefore a need to introduce the monitoring of TB patients for therapyrelated hepatotoxicity and performance of these viral infections.

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“…Similar findings have been reported in different studies [2,4,5,11,[17][18][19][20][21][22]. Hepatitis B virus carrier might be at a higher risk of contracting TB.…”

Section: Ethical Approvalsupporting

confidence: 91%

“…Several studies report an increased coinfection with HIV and/or HBV in TB patients [2,[10][11][12]. However, there is paucity of published data on these viral infections among tuberculosis patients in Nigeria.…”

Section: Introductionmentioning

confidence: 99%

Parallel and Overlapping Infection of Human Immunodeficiency Virus and Hepatitis B Virus Among Tuberculosis Patients Attending A Tuberculosis/Leprosy Referral Centre in Central Nigeria: A Cross-Sectional Study

Gri¹,

Oti²,

Ca³

2018

J Transl Gastroenterol Clin Hepatol

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“…32 Anecdotally, our experience is that HIV-positive clinical cases have increased extrapulmonary involvement compared to HIV-negative cases, and therefore, inclusion of clinical cases could have strengthened the association of HIV with TB treatment complexities and outcomes. There are mixed data on the association of hepatitis C virus (HCV) infection with TB outcomes, 33,34 and the lack of association of HCV infection with TB outcomes in our cohort could be due to small sample size. The lack of data on duration of symptoms before presentation and healthcare encounters before TB diagnosis cohort limits conclusions on measures to improve outcomes.…”

Section: Discussionmentioning

confidence: 87%

Treatment Complexities Among Patients with Tuberculosis in a High HIV Prevalence Cohort in the United States

Bizune

Kempker

Kagei

et al. 2018

AIDS Research and Human Retroviruses

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The association between human immunodeficiency virus (HIV) infection and tuberculosis (TB) mortality has been studied extensively, but the impact of HIV on other clinically relevant aspects of TB care such as TB drug-related adverse events (AEs), hospital readmissions, and TB treatment duration is less well characterized. We describe the association of HIV infection with TB clinical complexities and outcomes in a high HIV prevalence cohort in the United States. This is a retrospective cohort study among patients treated for culture-confirmed TB between 2008 and 2015 at an inner-city hospital in Atlanta, GA. Univariate analysis was used to estimate association of HIV with TB treatment interruption due to AEs, hospital readmissions, and treatment duration. Final unfavorable TB treatment outcome was defined as death, loss to follow-up, or recurrent TB. Logistic regression modeling was used to estimate association of HIV with final unfavorable outcomes. Among 274 patients with TB, 96 (35%) had HIV coinfection. HIV-positive patients had more TB treatment interruptions due to AE (34% vs. 15%), were more likely to have a hospital readmission (50% vs. 21%), and received longer TB treatment (9.9 months vs. 8.8 months) compared to HIV-negative patients (p < .01 for all). HIV infection was not associated with final unfavorable outcomes in univariate [odds ratio (OR) = 1.86; confidence interval (95% CI) 0.99-3.49] or multivariate analysis (aOR = 1.13; 95% CI 0.52-2.39) (p ≥ .05 for both). While HIV infection was not associated with final unfavorable TB outcomes, TB/HIV coinfected patients had more complex treatment course underscoring the importance of maintaining resources and expertise to treat coinfected patients in our and similar settings.

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“…For this reason, liver function is tested before treatment. Although HCV coinfection has been shown to increase the risk of anti-TB drug-induced hepatotoxicity (Lomtadze et al 2013, Kim et al 2016) and death (Bushnell et al 2015), patients without symptoms of liver disease are not systematically tested for anti-HCV antibody and HCV RNA before beginning anti-TB therapy.…”

mentioning

confidence: 99%

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

Costi

Grandi

Halon

et al. 2017

Mem. Inst. Oswaldo Cruz

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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.

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Characteristics and TB treatment outcomes in TB patients with viral hepatitis, New York City, 2000–2010

Cited by 20 publications

References 29 publications

Parallel and Overlapping Infection of Human Immunodeficiency Virus and Hepatitis B Virus Among Tuberculosis Patients Attending A Tuberculosis/Leprosy Referral Centre in Central Nigeria: A Cross-Sectional Study

Parallel and Overlapping Infection of Human Immunodeficiency Virus and Hepatitis B Virus Among Tuberculosis Patients Attending A Tuberculosis/Leprosy Referral Centre in Central Nigeria: A Cross-Sectional Study

Treatment Complexities Among Patients with Tuberculosis in a High HIV Prevalence Cohort in the United States

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

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