High Rates of Chronic Hepatitis B and Tuberculosis Co-Infection Observed in Nationally Representative Quest Diagnostics Study
* Analysis of nearly 23 million lab tests reveals that only 1 in 3 patients with latent TB were also tested for chronic hepatitis B, despite similar risk factors in patients
* The results call for caution in the use of anti-tuberculosis treatments, which increase the risk of liver damage in patients co-infected with chronic hepatitis B virus DESCRIPTION:
The study was conducted by researchers from
Researchers evaluated anonymized data from the HBV surface antigen (HBsAg) and total antibody (HBcAb) tests, as well as the QuantiFERON® blood test series and T-SPOT®.TB blood test series. interferon gamma (IGRA) to assess latent tuberculosis infection. IGRA tests are recommended for many patients and generally considered more efficient and accurate than skin tests, which require multiple doctor appointments.[i][ii][iii].
Latent TB infection was defined as having a positive QuantiFERON or T-SPOT® test without a positive Mycobacterium tuberculosis complex (MTB) result or mycobacterial culture during the study period (as this would indicate active TB infection). QuantiFERON or T-SPOT® tests do not distinguish between active and latent.
Among patients tested for both infections, almost one in five (19.6%) with chronic hepatitis B also have latent tuberculosis, more than double the positive TB of patients without chronic hepatitis B (7, 3%). Among patients tested for both, the rate of positivity for chronic hepatitis B among those positive for latent tuberculosis was three times higher than for patients in whom latent tuberculosis was not found (1.5% against 0.5%).
Among the most significant results of the study, only one in three patients (32.3%) who tested positive for latent tuberculosis were also tested for HBV infection. Commonly used TB treatments can cause liver damage if given to patients who are also co-infected with HBV. The study also revealed that only 10.7% of patients with chronic HBV were also tested for latent tuberculosis.
The study authors wrote that the prevalence of co-infection is “substantial” and underscores the need for testing for co-infection “to mitigate the risk of drug-induced liver injury associated with anti-tuberculosis drugs in patients with concurrent chronic HBV”.
According to the main author
Other results showed concurrent testing increased with age, from 7.2% in patients under 18 to 29.5% in those over 70. When assessed by race/ethnicity, the highest rate of testing for latent tuberculosis was observed among black/
“Our nationally representative study provides important new insights into the magnitude of latent tuberculosis and HBV co-infection,” said the co-author.
Study highlights include nationwide and quality laboratory testing method results. Weaknesses include the lack of drugs and other clinical data to identify treatment models.
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Quest Diagnostics Health Trends(TM) is a series of scientific reports that provide information on health topics, based on the analysis of objective clinical laboratory data, to improve patient care, population health management and public health policies. Reports are based on
[i] T-SPOT.TB. Packing note. Oxford
[ii] Lewinsohn DM, Leonard MK, LoBue PA, et al. Official
[iv] Filardo TD, Feng P, Pratt RH, Price SF, Self JL. Tuberculosis –
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