Abstract
The prevalence of hepatitis C virus (HCV) infection among patients with tuberculosis (TB) has not been extensively investigated. Hepatotoxicity is the major adverse effect of anti TB drugs.
Aim: to assess the prevalence of HCV infection in patients with tuberculosis and its impact in the incidence of anti-tuberculosis drugs induced hepatotoxicity (DIH).
Subjects & Methods: the prevalence of HCV in patients with tuberculosis was estimated using PCR. Then patients were classified into 2 groups: group I (patients with HCV-TB coinfections) and group II (HCV-seronegative 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. The risk factors for developing DIH were; age ≥40, high baselines transaminases, ALP and total bilirubin, and low BMI. Most cases of DIH occurred during the 1st 4 weeks of starting therapy.
Conclusions: Tuberculosis and hepatitis C virus co-infection is common. HCV-positive patients with tuberculosis should be closely monitored during treatment especially if they had elevated baseline liver functions, old age and with low BMI.
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