Mohammed A. Agha

Prevalence of hepatitis C virus in patients with tuberculosis and its impact in the incidence of anti-tuberculosis drugs induced hepatotoxicity

HCV; Tuberculosis; Hepatotoxicity Abstract Background: The prevalence of hepatitis C virus (HCV) infection among patients with tuberculosis (TB) has not been extensively investigated, and very limited data on rates of HCV co-infection among patients with TB exists. Hepatotoxicity is the major adverse effect of three of the first line anti-TB agents: isoniazid (INH), rifampin (RIF), and pyrazinamide (PZA). Chronic liver disease raises a risk of hepatotoxicity during anti-tuberculosis treatment, up to three to five times more than TB patients who do not have viral infection. Aim: To assess the prevalence of HCV infection in patients with tuberculosis and its impact in the incidence of anti-tuberculosis drug induced hepatotoxicity (DIH). Subjects and methods: The prevalence of HCV in patients with newly diagnosed pulmonary or extrapulmonary tuberculosis was estimated using polymerase chain reaction (PCR). Then patients were classified into 2 groups: group I (patients with HCV-TB coinfections) and group II (HCVseronegative tuberculous patients). Baseline and monthly measuring liver transaminases was done before and following the start of 1st line anti-tuberculosis therapy. Results: The prevalence of HCV in patients with TB was 17.02%. Regarding DIH, in group I; 6 (40%) cases showed transient transaminase elevations and 6 (40%) cases developed DIH. In group II; 11 (20.75%) cases developed transient transaminase elevations and only 2 (3.78%) cases developed DIH, and there was a highly significant difference (<0.01) between both groups. Regarding the severity of DIH, in group I; 4 cases were mild, one case was moderate and one case was severe. While in group II, no cases was with severe DIH. The risk factors for developing DIH during anti-tuberculosis therapy were; age P40, high baselines transaminases, ALP and total bilirubin,