Risk factors of hepatitis during Anti-tuberculous treatment and implications of hepatitis virus load

Prevalence of hepatitis B virus infection among tuberculosis patients with or without HIV in Goiânia City, Brazil

“…25,26 Relative to other data reported in TB patients, the HBV prevalence determined in this study was similar to prevalence rates observed in Rio de Janeiro, Brazil (26.8%; 95% CI: 19.7-31.9) and Argentina (19.8%; 95% CI: 14.3-26.2), 12,13 but was higher than rates determined in Georgia (13%; 95% CI: 9.5-17.5) and Taiwan (11.7%; 95% CI: 6.8-15.5). 9,11 The high prevalence rates of HBV infection found in TB/HIVinfected patients and in patients with TB only were similar to those observed in Rio de Janeiro (35.8% and 14.6%, respectively). 12 Other studies have indicated that HBV and HIV infections have been found to increase the risk of anti-TB drug-induced hepatotoxicity that may necessitate discontinuation of treatment.…”

“…12 Other studies have indicated that HBV and HIV infections have been found to increase the risk of anti-TB drug-induced hepatotoxicity that may necessitate discontinuation of treatment. [8][9][10][11] Among the HBV infected patients, two developed hepatotoxicity: one patient during the first month of TB treatment (HBsAg/HBeAg-positive and had a high HBV DNA level: 6.7 × 10 6 copies/ml), while the other patient during the second month of TB treatment (had occult HBV infection with HBV DNA level of 1.9 × 10 2 copies/ml). In both cases, TB treatment adjustment was necessary (data not shown).…”

“…6 Moreover, HIV and/or HBV co-infections increase the risk of anti-TB drug-induced hepatotoxicity, which may necessitate discontinuation of treatment. [8][9][10][11] Since TB and hepatitis B may co-exist in patients from endemic areas, some reports suggest to provide HBV testing to TB patients, which may improve TB management and treatment (through careful monitoring and treatment adjustment when necessary). 9,11 Although hepatitis B may also impact patients with TB, there is currently very little data on HBV prevalence and risk factors among TB patients 8,9,11-14 ; and no data are available regarding hepatitis B occult and HBV genotypes infecting these patients.…”

An Update on Drug-induced Liver Injury

“…76 Another retrospective study found a slightly higher but non significant incidence of anti-TB DILI in inactive carriers with HBV DNA <10 5 copies/ml. 77 In the setting of chronic hepatitis B and C, the challenge is to determine whether the rise in transaminases or bilirubin is a signal of drug-induced hepatitis or a flare of underlying hepatitis B or C. 68 Hepatitis B flare is not uncommon as suggested by a recent report, 78 and viral replication status including HBV DNA studies may be necessary to differentiate between virus-induced flare from DILI. Nevertheless, caution should be exercised in carriers with hepatitis B or C, the drugs withheld until such time the adjudication process is complete, and the results of viral DNA or RNA levels are available.…”

Evaluation of Drug Induced Liver Injury in Tuberculosis and Hepatitis Coinfection by Liver Fibrosis Index Score

“…In another study DILI was 16% in HBV infected individuals compared to 4.7 non infected (P<0.001) [31].…”