Table 1 - uploaded by Julio Croda
Content may be subject to copyright.
Source publication
BACKGROUND: Due to environmental and social conditions inherent to incarceration, tuberculosis (TB) and hepatitis B virus (HBV) are major diseases among prison inmates.
OBJECTIVE: To determine overall and occult HBV infection (OBI) prevalence rates, risk factors and genotype distribution among inmates with active TB.
STUDY DESIGN: A cross-sectional...
Citations
... Latent tuberculosis is underdiagnosed in Brazil, an extremely worrying fact in a country considered as an endemic area for tuberculosis, where different health programs are established to eliminate the disease (1) . Concerningly, many patients with CD and UC will at some point be subjected to medications that may increase the risk of developing this infection, thereby establishing continuous screening for these patients could be of paramount importance (8,11,(18)(19)(20)(21) . It is recognized that people with latent tuberculosis have a high risk of progressing to active tuberculosis, one of the ways to identify these cases is through the screening test TST (tuberculin skin test) (2,12) . ...
Background
Latent tuberculosis (LTB) is a condition where the patient is infected with Mycobacterium tuberculosis but does not develop active TB. There’s a possibility of tuberculosis (TB) activation following the introduction of anti-TNFs.
Objective
To assess the risk of biological therapy inducing LTB during inflammatory bowel diseases (IBD) treatment over 15 years in a high-risk area in Brazil.
Methods
A retrospective study of an IBD patients’ database was carried out in a private reference clinic in Brazil. All patients underwent TST testing and chest X-ray prior to treatment, and once a year after starting it. Patients were classified according to the Montreal stratification and risk factors were considered for developing TB.
Results
Among the analyzed factors, age and gender were risk factors for LTB. DC (B2 and P) and UC (E2) patients showed a higher number of LTB cases with statistical significance, what was also observed for adalimumab and infliximab users, compared to other medications, and time of exposure to them favored it significantly. Other factors such as enclosed working environment have been reported as risk.
Conclusion
The risk of biological therapy causing LTB is real, so patients with IBD should be continually monitored. This study reveals that the longer the exposure to anti-TNFs, the greater the risk.
Keywords:
Biologics; Crohn’s disease; ulcerative colitis; epidemiology
... Previous studies have reported HBV infection prevalence in individuals with TB: Rio de Janeiro, Brazil (26.8%; 95% CI: 19.7-31.9), 34 Argentina (19.8%; 95% CI: 14.3-26.2), 35 Taiwan (11.7%; 95% CI: 6.8-15.5) ...
One third of the world population has a history of exposure to the hepatitis B virus (HBV), and two billion people are infected with latent tuberculosis (TB). Occult hepatitis B infection (OBI) is defined as the presence of replicative-competent HBV DNA in the liver with detectable or undetectable HBV DNA in the serum of individuals testing negative for the HBV surface antigen (HBsAg). Screening with HBV DNA could identify OBI and significantly reduce carriers and complications of chronic hepatitis B (CHB). This study aims to assess HBV serological markers and OBI molecular diagnosis among people with TB in Mashhad, northeastern Iran. We have performed HBV serological markers (HBsAg, HBc antibodies (Ab) and HBs Ab) in 175 participants. Fourteen HBsAg+ sera were excluded for further analysis. The presence of HBV DNA (C, S, and X gene regions) was assessed by the qualitative real-time PCR (qPCR) method. Frequencies of HBsAg, HBc, and HBs Ab were 8% (14/175), 36.6% (64/175), and 49.1% (86/175), respectively. Among these 42.9% (69/161) were negative for all HBV serological markers. The S, C, and X gene regions were positive in 10.3% (16/156), 15.4% (24/156), and 22.4% (35/156) of participants, respectively. The total OBI frequency was estimated at 33.3% (52/156) when based on detecting one HBV genomic region. Twenty-two and 30 participants had a seronegative and seropositive OBI, respectively. Thorough screening of high-risk groups with reliable and sensitive molecular methods could lead to OBI identification and decrease CHB long-term complications. Mass immunization remains critical in preventing, reducing, and potentially eliminating HBV complications.
... При этом около 20% пациентов погибает от ко-инфекции: ВИЧ, вирусного гепатита В и С [2]. Превалентность гепатита В у пациентов с туберкулезом находится в пределах 0,5-44,0%, гепатита С -3,4-44,6% [3][4][5][6]. ...
Despite the study of the epidemiology of tuberculosis and its co-infection over the past decades, a number of questions remain, including those related to the impact of co-infection on survival depending on the chosen tuberculosis treatment regimen, the likelihood of adverse outcomes in the form of gastrointestinal bleeding and cirrhosis of the liver and their relationship with the therapy of the underlying disease. The purpose of the study: to evaluate the survival of patients with tuberculosis who have co-infection (viral hepatitis B and C) and receive multicomponent chemotherapy. Materials and Methods: The study included all patients who received treatment for active tuberculosis and had viral hepatitis B and/or C from 01/01/2004 to 12/31/2020. A total of 1687 patients were included. Twenty-two patients were lost to follow-up, and attempts to ascertain their clinical status were unsuccessful. Vital status was assessed in all patients. The mean duration of follow-up was 10.5±3.0 years. Median follow-up was 11.3 years (95% confidence interval (CI) 8.2-14.3). The average age of the cohort was 53.3±7.7 years. The study assessed survival and all-cause mortality annually. Results: The frequency of chronic hepatitis B in the group of patients with active tuberculosis was 3.8%, hepatitis C - 14.8%, hepatitis B and C - 0.5% of cases. Such an incidence of viral hepatitis is associated with a high frequency of illicit drug users (62.4%). It should be noted that the frequency of hepatitis treatment was low and amounted to 8.7%. When assessing the contribution of hepatitis B and C to the mortality of patients with active tuberculosis, it was found that hepatitis is not a predictor of death in patients. At the same time, patients who did not receive hepatitis therapy had a higher risk of death (unadjusted odds ratio (OR) - 1.28, 95% CI 1.04-1.65). The adjusted OR for hepatitis B was - 1.87 95% CI 0.67-1.52, C - 1.24 95% CI 0.90-2.18, B and C - 1.72 95% CI 0.99-2.02. Conclusion: The presence of chronic viral hepatitis B and/or C in patients with active tuberculosis did not affect mortality from all causes and regardless of the type of virus during a long period of observation. Patients who did not receive treatment for viral hepatitis and who had a history of tuberculosis had a higher risk of death from all causes (OR 1.28, 95% CI 1.04-1.65).
... Unprotected sexual intercourse, syringe sharing, inadequate access to health services, and tattooing in inappropriate places are important predictors of HBV transmission [15]. Many times, individuals are already admitted to the prison unit carrying the virus [16], and the prison system may act as a hotspot for virus dispersion beyond the incarcerated population [17][18][19]. ...
Hepatitis B viral infection (HBV) in prisons poses serious public health challenges because it significantly contributes to the increase in both morbidity and mortality indicators worldwide. Research has shown high HBV prevalence among inmates when compared to the general population. In this study, we estimated the prevalence of HBV exposure and its risk factors among 1,132 inmates detained in high security institutions. A cross-sectional, epidemiological study was carried out in 11 male-only prisons in the State of Paraná, Brazil, between May 2015 to December 2016. HBV exposure was explored using a variety of methods, including HBsAg, anti-HBs, and total anti-HBc. Data were analyzed using univariate and multivariate techniques. The overall prevalence of HBV exposure was 11.9% (95% CI: 10.9–12.8), totaling 135 individuals. In the multivariate analyses, risk factors that remained statistically significant were related to the penitentiary location (Francisco Beltrão; OR = 5.59; 95% CI: 3.32–9.42), age (over 30 years; OR = 5.78; 95% CI: 3.58–9.34), undergoing tattooing procedures in prison (OR = 1.64; 95% CI: 1.03–2.60), self-reported sexual activities with a known drug user (OR = 1.67; 95% CI: 1.12–2.48) and having a history of previous history of hepatitis B or C infection (OR = 2.62; 95% CI: 1.48–4.64). The findings indicate that public policies–including vaccination, early diagnosis, harm reduction strategies, and adequate treatment–should be designed and delivered in the same way for both the incarcerated and the general population in order to reduce the prevalence of HBV and its associated consequences.
... This finding suggests that Maranhão State is, in fact, a Brazilian state where HBV infection is a more significant aggravation than what is considered for most regions of the country because the results found here are equal to or above those of recent Brazilian studies on high-risk J o u r n a l P r e -p r o o f populations, including prison inmates, HIV-positive individuals or those with coagulopathies that require frequent blood transfusions [17][18][19]. ...
Introduction and objectives:
Research in shown hepatitis B (HBV) and Delta viral (HDV) world public health problem. This study aims estimate the prevalence rates of HBV and HDV infection in five municipalities of Maranhão, Northeastern Brazil.
Materials and methods:
A total sample between 3856 and 4000 individuals. Questionnaires were administered sociodemographic characteristics and factors associated with transmission. Patients were tested for the markers hepatitis B virus surface antigen (HBsAg), anti-hepatitis B core antigen (anti-HBc), and antibodies against hepatitis Delta virus (anti-HDV). Factors associated with HBV were detected by means of multivariate Poisson regression.
Results:
Overall, 3983 subjects were included. Ninety-two of the participants were HBsAg-positive (2.30% 95% CI: 1.80-2.80), and anti-HBc was detected in 1535 (38.50% 95% CI: 37-40). The factors associated with the presence of anti-HBc were: (1) Municipality (P<0.001); Age (P<0.001); School education (P<0.001); Illicit drug use (P=0.001); non HBV vaccine (P=0.041). Among the HBsAg carriers, eight were anti-HDV-positive (8.69%; 95% CI=2.90-14.40). Most frequent HBV genotype found was D4. Only HDV genotype was HDV-8.
Conclusion:
HBV exhibited intermediate endemicity in the studied region. Traditional factors were associated with exposure to the virus. The presence of the HDV was confirmed. Most frequent HBV and HDV genotypes were unlike the ones currently described in Brazil.
... The prevalence of hepatitis B viral infection among tuberculosis patients ranges from 0.5 to 44% [8][9][10][11]. Hepatitis C virus burden among tuberculosis patients ranges from 3.4 -44.6% [12][13][14]. ...
Background:
This study was conducted to estimate the prevalence, determinants of hepatitis B, hepatitis C and the survival of tuberculosis patients until drug-induced hepatitis.
Methods:
Prospective cohort study design was implemented. The data were collected from September 2016 - May 2019. Systematic random sampling was used to select the study participants. Baseline data were collected before the patient starts DOTS, the sign of liver toxicity was assessed every week. Tuberculosis treatment outcomes and WHO clinical stage was recorded at the end of 6th months. Descriptive statistics were used to estimate the prevalence of hepatitis B, hepatitis C viral infections and their effect on tuberculosis treatment outcomes. Binary logistic regression was used to identify the determinants of hepatitis B and C infections. The Kaplan Meier survival curve was used to estimate the survival of tuberculosis patient and Cox regression was used to identify the predictors of drug-induced hepatitis.
Results:
A total of 3537 tuberculosis patients were followed. The prevalence of hepatitis B and C viral infection among tuberculosis patients were 15.1 and 17.3% respectively. Hepatitis B viral infection among tuberculosis patients was associated with alcohol, sex, HIV, chronic illness. Hepatitis C viral infection among tuberculosis patients was associated with alcohol, sex, HIV, chronic illness. The incidence density for liver toxicity among tuberculosis patients was 843/15707 person-months and liver toxicity was determined by HIV, Hepatitis B, Hepatitis C, the severity of tuberculosis and chronic illnesses.
Conclusion:
Decision-makers should consider incorporating screening for hepatitis B and C viral infection during tuberculosis treatment.
... In recent decades, there has been a decrease in the prevalence of hepatitis B virus (HBV) infection in the central region of Brazil due to vaccination coverage, especially among young people and children (Pereira et al., 2009;Lindenberg et al., 2013;Souto, 2016). Despite this, several studies conducted in the same region have shown a high prevalence of HBV infection in vulnerable populations, including prisoners, drug users, truck drivers, homosexual men and recyclable waste collectors (Seage et al., 1997;Tavares-Neto et al., 2004;Neaigus et al., 2007;Nunes et al., 2007;Matos et al., 2008;Rozman et al., 2008;Stief et al., 2010;Freitas et al., 2014;Iglecias et al., 2016). ...
Objectives:
To evaluate the epidemiological and molecular features of HBV infection among recyclable waste collectors.
Methods:
The participants were recruited from the dumping ground and recycling cooperatives in Campo Grande, Brazil, and were screened for hepatitis B and C, and HIV serological markers by ELISA, confirmed by PCR.
Results:
Among 278 participants, 63.7% (95% CI: 58.0 - 69.3) was considered susceptible to HBV infection. The prevalence rate of HBV exposure was 10.1% (95% CI: 6.5 - 13.6) and 0.4% (95% CI: 0.1 - 0.6) was chronic carrier. Age ≥45 years (AOR = 7.15), history of homosexual contact (AOR = 5.29), tattoo (AOR = 4.92) and surgery (AOR = 2.89) were factors associated with ever infection. Age 18-25 years (AOR = 4.63), educational level ≥9 years (AOR = 1.98) and knowledge about HBV transmission (AOR = 3.08) were associated with serological HBV vaccination like profile (26.2%; 95% CI: 21.1 - 31.4).
Conclusions:
Despite the availability and efficacy of HBV vaccine, this study found high HBV exposure and proportion of susceptible adults in a low endemic area. Vaccination and screening campaigns using accessible language to the economically disadvantaged populations can reduce the number of people susceptible to HBV infection.
... In the final multilevel model adjusted per CF and overcrowding at the second level, no sociodemographic characteristics lost association. Young adults (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) Alcohol consumption had a slight association (PRa 1.14; 95% CI: 1.01-1.28), and tobacco use lost significance in the multivariate model. ...
... Prison inmates are exposed to high transmission rates of infectious diseases such as TB, HIV and hepatitis B [35]. It is well known that the association between HIV and TB [10,14,15,36], most likely explained by the HIV-induced depletion of CD4 T cells which increases not only the susceptibility to contracting TB [37] but of reactivation. ...
Objective
To estimate the prevalence of self‐reported tuberculosis TB diagnosed at Peruvian correctional facilities (CFs), and their associated factors.
Methods
Cross‐sectional study based on secondary analysis of the National Census held in all Peruvian CFs in 2016. Outcome was defined as self‐reported TB diagnosed by a healthcare professional intra‐penitentiary. A descriptive bivariate analysis was carried out, followed by multivariate analysis using Poisson regression in order to calculate the adjusted prevalence ratios (PRa). Additionally, a mixed effects multilevel model adjusted by CFs as clusters was performed.
Results
Of 77 086 prison inmates in 66 CFs participated in the original census, of which 69 890 were included. Of these, 1754 self‐reported TB diagnosed intra‐penitentiary, yielding a prevalence of 2510/100 000 PDL. In the final model, self‐reported TB was associated with younger age, male gender, lower educational level, not having a stable partner, having prison readmissions and having relatives in prison. There was also strong association with HIV/AIDS (PRa 2.77; 1.84–4.18), STIs (PRa 2.13; 1.46–3.10), DM (PRa 1.99; 1.59–2.50) and recreational drugs use (PRa 1.41; 1.23–1.61). The mixed model showed significant variance for belonging to different CFs (2.13; 1.02–4.44) and CF overcrowding (3.25; 1.37–7.71).
Conclusions
Self‐reported TB prevalence found was higher than reported by other lower/lower‐middle income countries. Demographic factors, individual clinical features and overcrowding increases the likelihood of self‐reported TB.
Introduction. For the first time, in the Republic of Moldova, there was established the sero-prevalence of viral hepatitis B, C and E markers in patients with tuberculosis depending on gender, age and geographical areas. Material and methods. 200 blood samples were collected from patients with tuberculosis and tested by the immuno-fermentative method for presence of viral hepatitis B, C and E markers. Results. Following the investigations, it was established that the seroprevalence of the anti-HEV Ig marker in patients with tuberculosis is 12.0±2.3%. The seroprevalence of viral hepatitis B marker HBsAg in patients with tuberculosis was 13.5±2.4%, and that of viral hepatitis C anti-HCV-9.0±2.0%. The study of investigations results for the presence of nominated markers depending on the geographical areas showed a significant statistically difference in the sero-prevalence of the anti-HEV IgG marker in TB patients in the Central area of the country compared to the Southern area(p<0.05). Conclusions. Patients with tuberculosis showed a high level of seroprevalence of viral hepatitis marker viz. HBsAg-13.5±2.4%; anti-HVC-9.0±2.0% and anti-HVE IgG-12.0±2.3%. People aged 40-49 and > 60 years were the most affected, including males.
Keywords:sero-prevalence, labora-tory investigations, viral hepatitis B, C and E, TB patients
Background:
While patients with hepatitis B virus (HBV) infection and tuberculosis (TB) have similar risk factors, little is known regarding the prevalence of HBV and TB coinfection. We aim to evaluate the prevalence of HBV among patients with TB across world regions.
Methods:
We systematically reviewed the literature using PubMed from inception through September 1, 2019, to identify studies that provided data to calculate HBV coinfection prevalence among adults with TB infection. Prevalence estimates of HBV coinfection among TB patients were stratified by world regions and calculated using meta-analyses with random-effects models.
Results:
A total of 36 studies met inclusion criteria (4 from the Africa region, 6 from the Americas region, 5 from the Eastern Mediterranean region, 2 from European region, 6 from Southeast Asia region, and 13 from the Western Pacific region). On meta-analysis, overall pooled HBV coinfection prevalence among TB patients was 7.1%, but varied by world region. Region-specific pooled HBV prevalence among TB patients was highest in Africa region [11.4%, 95% confidence interval (CI): 3.45-19.31] and Western Pacific region (10.8%, 95% CI: 8.68-12.84), and was lowest in the Americas (2.2%, 95% CI: 0.78-3.53). Sensitivity analyses yielded similar HBV prevalence estimates across world regions.
Conclusions:
In this meta-analysis, we observed HBV coinfection prevalence among TB patients to be 38% to 450% higher than published estimates from the Polaris group of region-specific overall HBV prevalence. Timely identification of HBV infection among TB patients will improve patient outcomes by allowing for closer clinical monitoring and management, which may reduce the risk of liver dysfunction and liver failure related to TB treatment.
