Prevalence of hepatitis C virus and human immunodeficiency virus in a group of patients newly diagnosed with active tuberculosis in Porto Alegre, Southern Brazil.
BACKGROUND
Porto Alegre is the Brazilian state capital with second highest incidence of tuberculosis (TB) and the highest proportion of people infected with human immunodeficiency virus (HIV) among patients with TB. Hepatitis C virus (HCV) infection increases the risk of anti-TB drug-induced hepatotoxicity, which may result in discontinuation of the therapy.


OBJECTIVE
The aim of this study was (i) to estimate prevalence of HCV and HIV in a group of patients newly diagnosed with active TB in a public reference hospital in Porto Alegre and (ii) to compare demographic, behavioural, and clinical characteristics of patients in relation to their HCV infection status.


METHODS
One hundred and thirty-eight patients with TB were tested for anti-HCV antibody, HCV RNA, and anti-HIV1/2 antibody markers. HCV RNA from real-time polymerase chain reaction (PCR)-positive samples was submitted to reverse transcription and PCR amplification. The 5' non-coding region of the HCV genome was sequenced, and genotypes of HCV isolates were determined.


RESULTS
Anti-HCV antibody, HCV RNA, and anti-HIV antibodies were detected in 27 [20%; 95% confidence interval (CI), 13-26%], 17 (12%; 95% CI, 7-18%), and 34 (25%; 95% CI, 17-32%) patients, respectively. HCV isolates belonged to genotypes 1 (n = 12) and 3 (n = 4). Some characteristics were significantly more frequent in patients infected with HCV. Among them, non-white individuals, alcoholics, users of illicit drugs, imprisoned individuals, and those with history of previous TB episode were more commonly infected with HCV (p < 0.05).


CONCLUSIONS
HCV screening, including detection of anti-HCV antibody and HCV RNA, will be important to improving the management of co-infected patients, given their increased risk of developing TB treatment-related hepatotoxicity.
Secretaria Estadual da Saúde do Rio Grande do Sul, Fundação Estadual de Produção e Pesquisa em Saúde, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil.
Cintia
C
Costi
Secretaria Estadual da Saúde do Rio Grande do Sul, Fundação Estadual de Produção e Pesquisa em Saúde, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil.
Tarciana
T
Grandi
Secretaria Estadual da Saúde do Rio Grande do Sul, Fundação Estadual de Produção e Pesquisa em Saúde, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil.
Maria Laura
ML
Halon
Universidade Luterana do Brasil, Canoas, RS, Brasil.
Márcia Susana Nunes
MS
Silva
Secretaria Estadual da Saúde do Rio Grande do Sul, Fundação Estadual de Produção e Pesquisa em Saúde, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil.
Cláudia Maria Dornelles da
CM
Silva
Secretaria Estadual da Saúde do Rio Grande do Sul, Fundação Estadual de Produção e Pesquisa em Saúde, Instituto de Pesquisas Biológicas, Laboratório Central do Estado, Porto Alegre, RS, Brasil.
Tatiana Schäffer
TS
Gregianini
Universidade de Santa Cruz do Sul, Programa de Pós-Graduação em Promoção da Saúde, Santa Cruz do Sul, RS, Brasil.
Lia Gonçalves
LG
Possuelo
Secretaria Estadual da Saúde do Rio Grande do Sul, Hospital Sanatório Partenon, Porto Alegre, RS, Brasil.
Carla Adriane
CA
Jarczewski
Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil.
Christian
C
Niel
Secretaria Estadual da Saúde do Rio Grande do Sul, Fundação Estadual de Produção e Pesquisa em Saúde, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil.|Universidade Luterana do Brasil, Canoas, RS, Brasil.
Maria Lucia Rosa
ML
Rossetti
D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D060085:Coinfection / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D060888:Real-Time Polymerase Chain Reaction; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
D015483:HIV Antibodies; D018937:Hepatitis C Antibodies; D012367:RNA, Viral