Background: China has a high prevalence of tuberculosis and hepatitis B virus infection. The purpose of this study was to determine whether HBV coinfection increases the risk of incidence of drug-induced hepatotoxicity among patients on anti-tuberculosis therapy.
Methods: This retrospective study was carried out at the First Affiliated Hospital, School of Medicine, Zhejiang University, from 2013 to 2017. All enrolled patients were confirmed HBsAg-positive for a duration of at least 6 months and coinfected with mycobacterium tuberculosis.
Results: A cohort of 90 patients was analyzed. The incidence of liver damage and liver failure was 51.11% (n = 46) and 22.22% (n = 20), respectively. By multivariate analysis, initial albumin <35 g/l (P = 0.004, odds ratio 6.162, 95% confidence interval 1.767-21.486) was an independent risk factor for liver failure, but prophylactic antiviral treatment (P < 0.001, odds ratio 0.033, 95% confidence interval 0.007-0.154) was an independent protective factor for liver failure. Of the 90 patients, 20 developed liver failure, none of the patients with liver failure received prophylactic antiviral therapy, and 6 of those patients died of liver failure.
Conclusions: Prophylactic antiviral treatment reduces the incidence of liver failure in patients coinfected with Mycobacterium tuberculosis and hepatitis B virus; therefore, it is recommended that prophylactic antiviral treatment be administered while receiving anti-tuberculosis treatment in patients coinfected with Mycobacterium tuberculosis and hepatitis B virus.
Keywords: Anti-tuberculosis treatment; Drug-induced liver injury; Hepatitis B virus infection; Mycobacterium tuberculosis.
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