Association of Treated and Untreated Chronic Hepatitis C With the Incidence of Active Tuberculosis Disease: A Population-Based Cohort Study

Hepatitis C virus (HCV) infection causes dysregulation and suppression of immune pathways involved in the control of tuberculosis (TB) infection. However, data on the role of chronic hepatitis C as a risk factor for active TB are lacking. We sought to evaluate the association between HCV infection a...

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Bibliographic Details
Published in:Clinical infectious diseases 2023-01, Vol.76 (2), p.245-251
Main Authors: Baliashvili, Davit, Blumberg, Henry M, Benkeser, David, Kempker, Russell R, Shadaker, Shaun, Averhoff, Francisco, Gvinjilia, Lia, Adamashvili, Natalia, Magee, Matthew, Kamkamidze, George, Zakalashvili, Mamuka, Tsertsvadze, Tengiz, Sharvadze, Lali, Chincharauli, Mamuka, Tukvadze, Nestan, Gandhi, Neel R
Format: Article
Language:English
Subjects:
Adult
Cohort Studies
Hepacivirus
Hepatitis C - epidemiology
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - drug therapy
Hepatitis C, Chronic - epidemiology
Humans
Incidence
Latent Tuberculosis - complications
Major
Risk Factors
Tuberculosis - complications
Tuberculosis - epidemiology
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Summary:Hepatitis C virus (HCV) infection causes dysregulation and suppression of immune pathways involved in the control of tuberculosis (TB) infection. However, data on the role of chronic hepatitis C as a risk factor for active TB are lacking. We sought to evaluate the association between HCV infection and the development of active TB. We conducted a cohort study in Georgia among adults tested for HCV antibodies (January 2015-September 2020) and followed longitudinally for the development of newly diagnosed active TB. Data were obtained from the Georgian national programs of hepatitis C and TB. The exposures of interest were untreated and treated HCV infection. A Cox proportional hazards model was used to calculate adjusted hazard ratios (aHRs). A total of 1 828 808 adults were included (median follow-up time: 26 months; IQR: 13-39 months). Active TB was diagnosed in 3163 (0.17%) individuals after a median of 6 months follow-up (IQR: 1-18 months). The incidence rate per 100 000 person-years was 296 among persons with untreated HCV infection, 109 among those with treated HCV infection, and 65 among HCV-negative persons. In multivariable analysis, both untreated (aHR = 2.9; 95% CI: 2.4-3.4) and treated (aHR = 1.6; 95% CI: 1.4-2.0) HCV infections were associated with a higher hazard of active TB, compared with HCV-negative persons. Adults with HCV infection, particularly untreated individuals, were at higher risk of developing active TB disease. Screening for latent TB infection and active TB disease should be part of clinical evaluation of people with HCV infection, especially in high-TB-burden areas.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciac786