Association of Treated and Untreated Chronic Hepatitis C With the Incidence of Active Tuberculosis Disease: A Population-Based Cohort Study.
Association of Treated and Untreated Chronic Hepatitis C With the Incidence of Active Tuberculosis Disease: A Population-Based Cohort Study.
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DOI：
10.1093/cid/ciac786
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发表时间：
2023-01-13
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影响因子：
--
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中科院分区：
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--
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丙型肝炎病毒（HCV）感染导致参与结核病（TB）感染控制的免疫途径失调和抑制。然而，缺乏关于慢性丙型肝炎作为活动性结核病风险因素的数据。我们试图评估HCV感染与活动性结核病发展之间的关系。我们在格鲁吉亚对接受HCV抗体检测的成年人进行了一项队列研究（2015年1月至2020年9月），并对新诊断的活动性结核病的发展进行了纵向随访。数据来自格鲁吉亚丙型肝炎和结核病国家计划。关注的暴露是未经治疗和经治疗的HCV感染。使用考克斯比例风险模型计算调整后的风险比（aHR）。共纳入1 828 808名成人（中位随访时间：26个月; IQR：13-39个月）。在中位随访6个月（IQR：1-18个月）后，3163（0.17%）例患者被诊断为活动性结核病。在未经治疗的HCV感染者中，每10万人-年的发病率为296例，经治疗的HCV感染者为109例，HCV阴性者为65例。在多变量分析中，与HCV阴性者相比，未经治疗（aHR = 2.9; 95%CI：2.4-3.4）和治疗（aHR = 1.6; 95%CI：1.4-2.0）的HCV感染与活动性TB的风险更高相关。HCV感染的成年人，特别是未经治疗的人，患活动性结核病的风险更高。筛查潜伏性结核感染和活动性结核病应成为HCV感染者临床评估的一部分，特别是在结核病高负担地区。
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.
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影响因子：
13.2
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Ai JW;Ruan QL;Liu QH;Zhang WH
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