Title |
High incidence of tuberculosis in patients treated for hepatitis C chronic infection
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Published in |
Brazilian Journal of Infectious Diseases, February 2016
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DOI | 10.1016/j.bjid.2015.12.003 |
Pubmed ID | |
Authors |
Silvia Naomi de Oliveira Uehara, Christini Takemi Emori, Renata Mello Perez, Maria Cassia Jacintho Mendes-Correa, Adalgisa de Souza Paiva Ferreira, Ana Cristina de Castro Amaral Feldner, Antonio Eduardo Benedito Silva, Roberto José Carvalho Filho, Ivonete Sandra de Souza e Silva, Maria Lucia Cardoso Gomes Ferraz |
Abstract |
Brazil is one of the 22 countries that concentrates 80% of global tuberculosis cases concomitantly to a large number of hepatitis C carriers and some epidemiological risk scenarios are coincident for both diseases. We analyzed tuberculosis cases that occurred during α-interferon-based therapy for hepatitis C in reference centers in Brazil between 2001 and 2012 and reviewed their medical records. Eighteen tuberculosis cases were observed in patients submitted to hepatitis C α-interferon-based therapy. All patients were human immunodeficiency virus-negative. Nine patients (50%) had extra-pulmonary tuberculosis; 15 (83%) showed significant liver fibrosis. Hepatitis C treatment was discontinued in 12 patients (67%) due to tuberculosis reactivation and six (33%) had sustained virological response. The majority of patients had a favorable outcome but one died. Considering the evidences of α-IFN interference over the containment of Mycobacterium tuberculosis, the immune impairment of cirrhotic patients, the increase of tuberculosis case reports during hepatitis C treatment with atypical and severe presentations and the negative impact on sustained virological response, we think these are strong arguments for latent tuberculosis infection screening before starting α-interferon-based therapy for any indication and even to consider IFN-free regimens against hepatitis C when a patient tests positive for latent tuberculosis infection. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Mexico | 1 | 33% |
United States | 1 | 33% |
Unknown | 1 | 33% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 3 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Brazil | 1 | 2% |
Unknown | 54 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 9 | 16% |
Student > Ph. D. Student | 6 | 11% |
Researcher | 4 | 7% |
Student > Doctoral Student | 4 | 7% |
Other | 3 | 5% |
Other | 14 | 25% |
Unknown | 15 | 27% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 18 | 33% |
Pharmacology, Toxicology and Pharmaceutical Science | 4 | 7% |
Immunology and Microbiology | 4 | 7% |
Biochemistry, Genetics and Molecular Biology | 3 | 5% |
Agricultural and Biological Sciences | 3 | 5% |
Other | 5 | 9% |
Unknown | 18 | 33% |