High incidence of tuberculosis in patients treated for hepatitis C chronic infection

High incidence of tuberculosis in patients treated for hepatitis C chronic infection

Author de Oliveira Uehara, Silvia Naomi Autor UNIFESP Google Scholar
Emori, Christini Takemi Autor UNIFESP Google Scholar
Perez, Renata Mello Google Scholar
Jacintho Mendes-Correa, Maria Cassia Google Scholar
Paiva Ferreira, Adalgisa de Souza Google Scholar
de Castro Amaral Feldner, Ana Cristina Autor UNIFESP Google Scholar
Benedito Silva, Antonio Eduardo Autor UNIFESP Google Scholar
Carvalho Filho, Roberto Jose Autor UNIFESP Google Scholar
de Souza e Silva, Ivonete Sandra Autor UNIFESP Google Scholar
Cardoso Gomes Ferraz, Maria Lucia Autor UNIFESP Google Scholar
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 alpha-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 alpha-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 alpha-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 alpha-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. (C) 2016 Elsevier Editora Ltda.
Keywords Hepatitis C
Tuberculosis
Alpha-interferon
Latent tuberculosis infection
xmlui.dri2xhtml.METS-1.0.item-coverage Rio De Janeiro
Language English
Date 2016
Published in Brazilian Journal Of Infectious Diseases. Rio De Janeiro, v. 20, n. 2, p. 205-209, 2016.
ISSN 1413-8670 (Sherpa/Romeo, impact factor)
Publisher Elsevier Brazil
Extent 205-209
Origin http://dx.doi.org/10.1016/j.bjid.2015.12.003
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000372813300014
SciELO ID S1413-86702016000200205 (statistics in SciELO)
URI https://repositorio.unifesp.br/handle/11600/57861

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