Adults with hepatitis C at increased risk for developing active TB
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People with hepatitis C, either treated or untreated, had an increased risk for developing active tuberculosis, according to data published in Clinical Infectious Diseases.
“Both hepatitis C and tuberculosis (TB) are among the leading infectious causes of morbidity and mortality globally, and there is a substantial overlap in population groups affected by these two infectious diseases,” Davit Baliashvili, a PhD graduate student in the department of epidemiology at the Emory University Rollins School of Public Health, told Healio.
“Furthermore, hepatitis C virus (HCV) can suppress immune pathways involved in the control of TB infection. However, whether hepatitis C is a risk factor for active TB is not well established due to a limited number of large-scale population-based studies,” Baliashvili said.
Because of this, Baliashvili and colleagues sought to evaluate the association between hepatitis C and the development of active TB in a large population-based cohort study involving more than 1.8 million adults from the eastern European country of Georgia. According to the study, they assessed patients tested for HCV antibodies between January 2015 and September 2020 and followed these patients longitudinally for the development of newly diagnosed active TB.
In total, 1,828,808 adults were included in the study, among whom active TB was diagnosed in 3,163 (0.17%) after a median of 6 months of follow-up. According to the study, the incidence rate per 100,000 person-years was 296 among people with untreated HCV infection, 109 among those with treated HCV infection and 65 among HCV-negative individuals.
Additionally, a multivariable analysis revealed that both untreated (adjusted HR=2.9; 95% CI: 2.4-3.4) and treated (aHR=1.6; 95% CI: 1.4-2) HCV infections were associated with a higher risk for active TB when compared with HCV-negative persons.
According to Baliashvili, these findings suggest that integrating TB diagnostic and prevention services into the hepatitis C programs might be beneficial and should be considered because he believes people with hepatitis C could benefit from screening for active TB disease and treatment for latent TB infection to identify TB early or prevent it from developing altogether.
“Our results support including people with hepatitis C among priority populations who would benefit from regular screening for TB,” Baliashvili said. “In addition, our study again highlights the importance of timely hepatitis C treatment, which might provide collateral benefit by decreasing the risk of TB, in addition to being highly effective against the hepatitis C itself. Together, these findings underscore a patient-centered, integrated approach to care to ensure the best outcomes for two leading global pandemics — TB and hepatitis C.”
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