Latent tuberculosis in patients with hepatitis C infection before receiving antiretroviral drugs

Abstract

Aim of the work Studying the prevalence of latent TB infection among people infected with hepatitis C virus for preventing emergence of active tuberclous disease during treatment of hepatitis C virus with antiviral drugs that cause immunosuppression. Patients and method The study was performed on 75 patients who were divided into two groups ; group A (hepatitis C group) which was 45 patients and group B (control group) which was 30 patients. A written consent was taken from patents who underwent the study. Patients underwent: 1. History taking. 2. Examination: general and local chest examination. 3. Radiology: chest x-ray. 4. tuberculin skin test with (PPD) 5. QuantiFERON TB testing (interferon gamma release assay {IGRA}). Results The mean age of (54.9±10.23) in group A (hepatitis C group) and (61.1±9.2) in group B (control group). In group A there are 30 males (66.7%) and 15 females (33.3%) while in group B there are 16 males (53.3%) and 14 females (46.7%) with no significance difference between the two groups. In group A there are 9 patients (20%) with positive tuberculin test and 36 patients with negative test while in group B there are 4 patients (13.3%) with positive test and 26 patients (86.7%) with negative test . there is no significant difference between the two groups regarding tuberculin test. Regarding QuantiFERON TB Gold test, In group A there are 15 patients (33.3%) with positive test and 30 patients (66,7%) with negative test while in group B there is 4 patients (13.3%) with positive test and 26 patients (86.7%) with negative test. There is significant difference between the studied groups regarding QuantiFERON TB gold test. Summary and conclusion People infected with hepatitis C virus should undergo testing for latent TB for preventing emergence of active tuberculous disease during treatment of hepatitis C virus with antiviral drugs that cause immunosuppression. QuantiFERON test is preferred more than tuberculin test in detecting latent TB in patient with hepatitis C because tuberculin test may be falsely negative in patient with immunosuppression and hepatic patients which may give unreliable results.