Aspectele coinfecției cu hepatite virale la pacienții cu tuberculoză
DOI:
https://doi.org/10.52556/2587-3873.2023.4(97).17Keywords:
tuberculoza, hepatită virală, TratamentAbstract
This study focuses on the impact of viral hepatitis (VH) co-infection on patients with tuberculosis (TB), specifically regarding liver impairment and treatment outcomes. The research is a descriptive, retrospective analysis of patients diagnosed with pulmonary TB and VH, who were hospitalized for treatment from 2019 to 2021. A comparison was made between the parameters of the study group (91 patients with pulmonary TB and VH) and the control group (113 patients with pulmonary TB but no VH). The odds ratio (OR) was calculated to determine the probability of developing TB in the presence of risk factors, with a 95% confidence interval (CI) used to assess precision. Data analysis was performed using Microsoft Office 2007 Excel. The study revealed a significant predominance of males in patients with pulmonary TB and VH, with the most common age range being between 30 and 50 years. Infiltrative pulmonary TB was the most frequent diagnosis, and microbiological confirmation of TB remained a challenge. The occurrence of complications was notably high in patients with pulmonary TB and VH. The study also observed a high rate of retreatment and cases of death among patients with TB and VH as treatment outcomes. Overall, the research provides valuable insights into the severity, progression, and treatment response of TB patients with co-existing viral hepatitis.
References
1. Amir F. Khan et al. Co-infection with hepatitis B in tuberculosis patients on anti-tuberculosis treatment and the final outcome. Cureus. 2021 Apr; 13(4): e14433. https://doi.org/10.7759/cureus.14433
2. Araujo-Mariz et al. Serological markers of hepatitis B and C in patients with HIV/AIDS and active tuberculosis. J Med Virol. 2016;88(6):996-1002. https://doi.org/10.1002/jmv.24432
3. Alyaquobi F. et al. Country-specific lockdown measures in response to the COVID-19 pandemic and its impact on tuberculosis control: a global study. J Bras Pneumol. 2022;48(2):e20220087. https://doi.org/10.36416/1806-3756/e20220087
4. Al-Khazraji A., Alkhawam H., Garrido B. Hepatitis B virus reactivation in an inactive carrier of chronic HBV after the initiation of treatment for tuberculosis. J Investig Med. 2016, 64:939. https://doi.org/10.1136/jim-2016-000120.56
5. Behzadifar M., Heydarvand S., Behzadifar M., Bragazzi NL. Prevalence of hepatitis C virus in tuberculosis patients: a systematic review and meta-analysis. Ethiop J Health Sci. 2019;29(1):945-56. https://doi.org/10.4314/ejhs.v29i1.17
6. Bao Y., Ma X., Rasmussen TP, Zhong X-B. Genetic Variations associated with antituberculosis drug-induced liver injury. Curr Pharmacol Rep. 2018;4(3): 171-81. https://doi.org/10.1007/s40495-018-0131-8
7. Chen L., Bao D., Gu L., Gu Y., Zhou L., Gao Z. et al. Co-infection with hepatitis B virus among tuberculosis patients is associated with poor outcomes during anti-tuberculosis treatment. BMC Infect Dis. 2018;18(1):295. https://doi.org/10.1186/s12879-018-3192-8
8. Fisher K., Vuppalanchi R., Saxena R. Drug-induced liver injury. Arch Pathol Lab Med. 2015;139(7):876-87. https://doi.org/10.5858/arpa.2014-0214-RA
9. Feleke BE, Feleke TE, Adane WG, Girma A. Impacts of hepatitis B and hepatitis C co-infection with tuberculosis, a prospective cohort study. Virol J. 2020, 17:113. https://doi.org/10.1186/s12985-020-01385-z
10. Lui GCY, Wong NS, Wong RYK et al. Antiviral therapy for hepatitis B prevents liver injury in patients with tuberculosis and hepatitis B coinfection. Clin Infect Dis. 2020, 70:660-6. https://doi.org/10.1093/cid/ciz241
11. Mo P., Zhu Q., Teter C., Yang R., Deng L., Yan Y. et al. Prevalence, drug- induced hepatotoxicity, and mortality among patients multi-infected with HIV, tuberculosis, and hepatitis virus. Int J Infect Dis. 2014;28:95-100. https://doi.org/10.1016/j.ijid.2014.06.020
12. Mosedale M., Watkins PB. Drug-induced liver injury: advances in mechanistic understanding that will inform risk management. Clin Pharmacol Ther. 2017; 101(4):469-80. https://doi.org/10.1002/cpt.564
13. de Oliveira et al. High incidence of tuberculosis in patients treated for hepatitis C chronic infection. Braz J Infect Dis. 2016;20(2):205-9. https://doi.org/10.1016/j.bjid.2015.12.003
14. Pedrosa M., Nogales S., Vergara M., Miquel M., Casas M., Dalmau B. Reactivation of peritoneal and pleural tuberculosis during hepatitis C treatment with direct-acting antivirals. Gastroenterol Hepatol. 2019;42(3): 174-5. https://doi.org/10.1016/j.gastrohep.2018.03.003
15. Rodrigues I., Aguiar A., Migliori GB, Duarte R. Impact of the COVID-19 pandemic on tuberculosis services. Pulmonology. 2022 May-Jun; 28(3):210-219. https://doi.org/10.1016/j.pulmoe.2022.01.015
16. Teschke R. Hepatotoxicity: molecular mechanisms and pathophysiology. Switzerland: Multidisciplinary Digital Publishing Institute; 2019. https://doi.org/10.3390/ijms20010211
17. World Health Organization. Global tuberculosis report 2022. Geneva. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022.
18. Global Tuberculosis Report 2020. Geneva: World Health Organization; 2020. https://www.who.int/teams/global-tuberculosis-programme/data.
19. Global strategy and targets for tuberculosis prevention, care and control after 2015 (Res. WHA67.1). In: Sixty-seventh World Health Assembly, Geneva, 19-24 May 2014. https://apps.who.int/iris/handle/10665/162760.
20. World Health Organization. The End TB Strategy- 2015.
21. World Health Organization. What is Hepatitis? Switzerland. Geneva. 2019.
22. World Health Organization. Hepatitis B. 2021. http://who.int/news-room/fact-sheets/detail/hepatitis-b.
23. Protocolul Clinic Național -123 "Tuberculoza la adult". 05.03.2020.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
