Authors: Chien, J-Y.¹; Huang, R-M.²; Wang, J-Y.³; Ruan, S-Y.⁴; Chien, Y-J.⁴; Yu, C-J.³; Yang, P-C.³

Source: The International Journal of Tuberculosis and Lung Disease, Volume 14, Number 5, May 2010 , pp. 616-621(6)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

OBJECTIVE: To study the impact of hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection on clinically significant transaminase elevation during short-course anti-tuberculosis treatment.

DESIGN: Retrospective observation study.

RESULTS: During standard anti-tuberculosis treatment of 295 patients with active pulmonary tuberculosis (TB) and normal baseline liver biochemical tests, 25 (8.5%) developed hepatitis and had a significantly higher mortality rate (32% vs. 7%, OR 6.22, 95%CI 2.0-17.6, P = 0.001). Multivariate analysis showed that HCV co-infected individuals were more likely to develop transaminase elevations (OR 3.43, 95%CI 1.14-10.35, P = 0.03) than those without HCV co-infection. They also had a longer duration of transaminase elevation than controls (43.3 ± 40.4 vs. 13.5 ± 8.6 days, P = 0.01). Co-infection with HBV was not associated with a higher rate of hepatitis but was associated with later onset (102 ± 68.7 vs. 37.0 ± 31.9 days, P = 0.01), higher peak alanine aminotransferase level and slower recovery (55.5 ± 62.9 vs. 15.4 ± 10.8 days, P = 0.01).

CONCLUSION: Even with normal baseline liver biochemical tests, HCV co-infection had a higher incidence and longer exacerbations of hepatitis during anti-tuberculosis treatment. We suggest that screening for HCV infection before starting anti-tuberculosis treatment is helpful in planning the frequency of follow-up visits.

Keywords: tuberculosis; hepatitis C virus infection; hepatitis B virus infection; hepatitis

Document Type: Regular paper

Affiliations: 1: Chest Hospital, Department of Health, Executive Yuan, Rende Township, Tainan County, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliu, Yun-Lin County, Taiwan; Department of Internal Medicine, Nat 2: Chest Hospital, Department of Health, Executive Yuan, Rende Township, Tainan County, Taiwan 3: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan 4: Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliu, Yun-Lin County, Taiwan

Publication date: 2010-05-01

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• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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