P63 The prevalence of viral hepatitis in patients undergoing anti-tuberculous therapy. (2nd December 2011)

• Record Type: Journal Article
• Authors: Asgheddi, M; Connell, D W; Nooredinvand, H A; Abdullah, M; O'Donoghue, M; Campbell, L; Lalvani, A; Wickremasinghe, M; Khan, S; Kon, O M
• Is Part Of: Thorax. Volume 66(2011)Supplement 4
• Page Start: A93
• Page End: A94
• Publication Date: 2011-12-02
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2011-201054c.63
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: One-third of the world's population is thought to be infected with Mycobacterium tuberculosis (Mtb); the highest incidence rates for active disease are found in the WHO's South-East Asian and African regions. Hepatitis B virus (HBV) and Hepatitis C virus (HCV) each infect about 0.3% of the UK population. HBV/HCV are treatable but largely asymptomatic until advanced liver disease and/or cancer. Screening for HBV/HCV is recommended in high-risk individuals but is not routinely performed in TB patients. HBV/HCV share similar epidemiological "hotspots" to TB, and several studies, primarily in South America and East Asia, have shown an increased prevalence of HBV/HCV in TB patients and an association between HBV/HCV and Drug Induced Liver Injury (DILI) following anti-TB therapy. No such analysis has been performed in the UK. Aims: To assess The prevalence of markers of HBV and HCV infection in patients undergoing anti-TB therapy. Whether serological evidence of HBV/HCV increases risk of DILI. Method: A prospective study on 429 TB patients receiving anti-TB therapy in a diverse urban TB clinic. Serological markers of HBV/HCV/HIV infection were documented. ALT was measured prior to treatment and 2–4 weeks after treatment initiation. DILI was defined as an ALT rise of greater than 2-times upper limit of normal following a normal pre-treatment level (<40 IU/ml). Results: 58.7% of patients were from either South-East Asia or Africa. 61 (14.2%) patients were isolated anti-HBc antibody positive (Anti-HBc), 11 (2.6%) were Hepatitis B surface antigen positive (HBsAg) and 7 (1.6%) were HCV antibody positive. The prevalence of active HBV/HCV infection was significantly higher than the estimated UK prevalence in this urban TB clinic. Three (5.3%) patients with serological evidence of HBV/HCV had DILI compared to 25 (9.5%) of those without. Conclusion: HBV/HCV prevalence is higher among TB patients and routine screening for viral hepatitis should be considered in this group. DILI was not increased in patients with serological markers of HBV/HCV.