High incidence of tuberculosis in patients treated for hepatitis C chronic infection
Data
2016
Autores
de Oliveira Uehara, Silvia Naomi 
Emori, Christini Takemi
Mostrar mais
Tipo
Artigo
Título da Revista
ISSN da Revista
Título de Volume
Resumo
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.
Descrição
Citação
Brazilian Journal Of Infectious Diseases. Rio De Janeiro, v. 20, n. 2, p. 205-209, 2016.