Hepatitis C Virus Infection Is Associated With an Increased Risk of Active Tuberculosis Disease: A Nationwide Population-Based Study.
Tuberculosis (TB) and hepatitis C virus (HCV) infection contribute to major disease mortality and morbidity worldwide. However, the causal link between HCV infection and TB risk remains unclear. We conducted a population-based cohort study to elucidate the association between HCV infection and TB disease by analyzing Taiwan National Health Insurance Database. We enrolled 5454 persons with HCV infection and 54,274 age- and sex-matched non-HCV-infected persons between January 1998 and December 2007. Time-dependent Cox proportional hazards regression analysis was used to measure the association between HCV infection and active TB disease. Incidence rate of active TB disease was higher among HCV infection than in control (134.1 vs 89.1 per 100,000 person-years; incidence rate ratio 1.51; P = 0.014). HCV infection was significantly associated with active TB disease in multivariate Cox regression (adjusted hazard ratio [HR] 3.20; 95% confidence interval [CI], 1.85-5.53; P < 0.001) and competing death risk event analysis (adjusted HR 2.11; 95% CI, 1.39-3.20; P < 0.001). Multivariate stratified analysis further revealed that HCV infection was a risk of active TB disease in most strata. This nationwide cohort study suggests that HCV infection is associated with a higher risk of developing active TB disease.
From the Division of Nephrology (P-HW), Department of Internal Medicine; Department of Family Medicine (Y-TL); Division of Pulmonary and Critical Care Medicine (C-CS), Department of Internal Medicine; Department of Community Medicine (H-YC); Department of Public Health (Y-TL, H-YC), College of Life Science; School of Pharmacy (K-PH), College of Pharmacy; Graduate Institute of Medicine (P-HW); and Department of Internal Medicine (C-CS), College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Ping-Hsun
PH
Wu
Yi-Ting
YT
Lin
Kun-Pin
KP
Hsieh
Hung-Yi
HY
Chuang
Chau-Chyun
CC
Sheu
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062072:Patient Acuity; D016016:Proportional Hazards Models; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology*