INCIDENCE OF TUBERCULOSIS AMONG HIV/HCV CO-INFECTED PATIENTS RECEIVING HEPATITIS C TREATMENT WITH PEGYLATED INTERFERON AND RIBAVIRIN IN GEORGIA.
Treatment of hepatitis C is necessary for ensuring higher life expectancy among HIV/HCV co-infected patients. However antiviral treatment for chronic HCV infection with Pegylated interferon (PEG-IFN) and Ribavirin (RBV) is associated with a variety of side effects. In Georgia up to 22% of HIV-infected patients were found to have active Tuberculosis (TB) and 22.4 to 32.6% had latent TB. The objective of this study was to describe the characteristics and clinical outcomes of tuberculosis in HIV/HCV co-infected patients receiving hepatitis C treatment with pegylated interferon and ribavirin and calculate incidence rate of TB. A retrospective study was conducted among HIV/HCV co-infected patients receiving antiviral treatment for chronic HCV infection at the Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia from December 2011 to May, 2015. A total of 420 HIV/HCV co-infected patients received HCV therapy with PEG-IFN and RBV during study period. Six of 420 patients developed TB while receiving PEG IFN + RBV therapy. These patients were on Antiretroviral treatment. Baseline HIV RNA load was <34 copies/ml and CD4+ cell counts >350 cells/mm3. No opportunistic infections were observed in all cases. Three of 6 patients had a previous positive tuberculin skin test (TST) result and had completed isoniazid chemoprophylaxis several years before TB diagnosis. In 2 patients TST was not performed. Only one patient had experienced a previous episode of TB and had completed the anti-TB therapy 1 year before hepatitis C treatment. In all patients TB was diagnosed during the PEG IFN + RBV therapy. Hepatitis C treatment was immediately stopped in all patients. The incidence rate of TB was 1.4 cases per 100 person-years (95% CI=0.58-2.97). Our study emphasizes the necessity of screening for latent TB prior to the initiation of chronic hepatitis C treatment with PEG IFN and RBV.
Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi; I. Javakhishvili Tbilisi State University, Faculty of Medicine, Georgia.
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Abutidze
Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi; I. Javakhishvili Tbilisi State University, Faculty of Medicine, Georgia.
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Bolokadze
Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi; I. Javakhishvili Tbilisi State University, Faculty of Medicine, Georgia.
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Chkhartishvili
Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi; I. Javakhishvili Tbilisi State University, Faculty of Medicine, Georgia.
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Sharvadze
Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi; I. Javakhishvili Tbilisi State University, Faculty of Medicine, Georgia.
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Tsertsvadze
D000328:Adult; D000998:Antiviral Agents / Q000737:chemistry / Q000627:therapeutic use*; D060085:Coinfection; D004359:Drug Therapy, Combination; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D016898:Interferon-alpha / Q000737:chemistry / Q000627:therapeutic use*; D008297:Male; D011092:Polyethylene Glycols / Q000737:chemistry*; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000453:epidemiology*
D000998:Antiviral Agents; D016898:Interferon-alpha; D011092:Polyethylene Glycols; D012254:Ribavirin