Prevalence of hepatitis C virus and human immunodeficiency virus in a group of patients newly diagnosed with active tuberculosis in Porto Alegre, Southern Brazil

• Published in: Memórias do Instituto Oswaldo Cruz Vol. 112; no. 4
• Main Authors: Costi, Cintia, Grandi, Tarciana, Halon, Maria Laura, Silva, Marcia Susana Nunes, Silva, Claudia Maria Dornelles da, Gregianin, Tatiana Schäffer, Possuelo, Lia Gonçalves, Jarczewski, Carla Adriane, Niel, Christian, Rossetti, Maria Lucia Rosa
• Format: Journal Article
• Language: English
• Published: Fundação Oswaldo Cruz, Fiocruz 22-10-2018
• Subjects: coinfection; genotypes; HCV; HIV; Southern Brazil; tuberculosis
• ISSN: 1678-8060

BACKGROUND Porto Alegre is the Brazilian state capital with second
highest incidence of tuberculosis (TB) and the highest proportion of
people infected with human immunodeficiency virus (HIV) among patients
with TB. Hepatitis C virus (HCV) infection increases the risk of
anti-TB drug-induced hepatotoxicity, which may result in
discontinuation of the therapy. OBJECTIVES The aim of this study was
(i) to estimate prevalence of HCV and HIV in a group of patients newly
diagnosed with active TB in a public reference hospital in Porto Alegre
and (ii) to compare demographic, behavioural, and clinical
characteristics of patients in relation to their HCV infection status.
METHODS One hundred and thirty-eight patients with TB were tested for
anti-HCV antibody, HCV RNA, and anti-HIV1/2 antibody markers. HCV RNA
from real-time polymerase chain reaction (PCR)-positive samples was
submitted to reverse transcription and PCR amplification. The 5′
non-coding region of the HCV genome was sequenced, and genotypes of HCV
isolates were determined. FINDINGS Anti-HCV antibody, HCV RNA, and
anti-HIV antibodies were detected in 27 [20%; 95% confidence interval
(CI), 13-26%], 17 (12%; 95% CI, 7-18%), and 34 (25%; 95% CI, 17-32%)
patients, respectively. HCV isolates belonged to genotypes 1 (n = 12)
and 3 (n = 4). Some characteristics were significantly more frequent in
patients infected with HCV. Among them, non- white individuals,
alcoholics, users of illicit drugs, imprisoned individuals, and those
with history of previous TB episode were more commonly infected with
HCV (p < 0.05). MAIN CONCLUSIONS HCV screening, including detection
of anti-HCV antibody and HCV RNA, will be important to improving the
management of co-infected patients, given their increased risk of
developing TB treatment-related hepatotoxicity.