TY - JOUR
T1 - Risk factors and algorithms to identify hepatitis C, hepatitis B, and HIV among Georgian tuberculosis patients
AU - Kuniholm, Mark H.
AU - Mark, Jennifer
AU - Aladashvili, Malvina
AU - Shubladze, N.
AU - Khechinashvili, G.
AU - Tsertsvadze, Tengiz
AU - del Rio, Carlos
AU - Nelson, Kenrad E.
N1 - Funding Information:
Supported in part by the NIH/AIDS International Training and Research Program of Emory University (D43 TW01042) and the Civilian Research and Development Foundation (CRDF Grant #7213 and GB1-2013).
PY - 2008/1
Y1 - 2008/1
N2 - Objectives: To determine prevalence, risk factors, and simple identification algorithms for HIV, hepatitis B, and hepatitis C co-infection; factors that may predispose for anti-tuberculosis therapy-induced hepatotoxicity. Methods: We recruited 300 individuals at in-patient tuberculosis hospitals in three cities in Georgia, administered a behavioral questionnaire, and tested for antibody to HIV, hepatitis C (HCV), hepatitis B core antigen (anti-HBc), and the hepatitis B surface antigen (HBsAg). Results: Of the individuals tested, 0.7% were HIV positive, 4.3% were HBsAg positive, 8.7% were anti-HBc positive, and 12.0% were HCV positive. In multivariable analysis, a history of blood transfusion, injection drug use, and prison were significant independent risk factors for HCV, while a history of blood transfusion, injection drug use, younger age at sexual debut, and a high number of sex partners were significant risk factors for HBV. Three-questionnaire item algorithms predicted HCV serostatus 74.1% of the time and HBV serostatus 85.2% of the time. Conclusions: Treatment of tuberculosis patients in resource-limited countries with concurrent epidemics of HCV, HBV, and HIV may be associated with significant hepatotoxicity. Serologic screening of tuberculosis patients for HBV, HCV, and HIV or using behavioral algorithms to identify patients in need of intensive monitoring during anti-tuberculosis therapy may reduce this risk.
AB - Objectives: To determine prevalence, risk factors, and simple identification algorithms for HIV, hepatitis B, and hepatitis C co-infection; factors that may predispose for anti-tuberculosis therapy-induced hepatotoxicity. Methods: We recruited 300 individuals at in-patient tuberculosis hospitals in three cities in Georgia, administered a behavioral questionnaire, and tested for antibody to HIV, hepatitis C (HCV), hepatitis B core antigen (anti-HBc), and the hepatitis B surface antigen (HBsAg). Results: Of the individuals tested, 0.7% were HIV positive, 4.3% were HBsAg positive, 8.7% were anti-HBc positive, and 12.0% were HCV positive. In multivariable analysis, a history of blood transfusion, injection drug use, and prison were significant independent risk factors for HCV, while a history of blood transfusion, injection drug use, younger age at sexual debut, and a high number of sex partners were significant risk factors for HBV. Three-questionnaire item algorithms predicted HCV serostatus 74.1% of the time and HBV serostatus 85.2% of the time. Conclusions: Treatment of tuberculosis patients in resource-limited countries with concurrent epidemics of HCV, HBV, and HIV may be associated with significant hepatotoxicity. Serologic screening of tuberculosis patients for HBV, HCV, and HIV or using behavioral algorithms to identify patients in need of intensive monitoring during anti-tuberculosis therapy may reduce this risk.
KW - Epidemiology
KW - Georgia
KW - HIV
KW - Hepatitis B
KW - Hepatitis C
KW - Hepatotoxicity
KW - Tuberculosis
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UR - http://www.scopus.com/inward/citedby.url?scp=37349004789&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2007.04.015
DO - 10.1016/j.ijid.2007.04.015
M3 - Article
C2 - 17644020
AN - SCOPUS:37349004789
SN - 1201-9712
VL - 12
SP - 51
EP - 56
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
IS - 1
ER -
