Cintia Costi1, Tarciana Grandi1, Maria Laura Halon1, Márcia Susana Nunes Silva2, Cláudia Maria Dornelles da Silva1, Tatiana Schäffer Gregianini3, Lia Gonçalves Possuelo4, Carla Adriane Jarczewski5, Christian Niel6,+, Maria Lucia Rosa Rossetti1,2
1Secretaria 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
2Universidade Luterana do Brasil, Canoas, RS, Brasil
3Secretaria 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
4Universidade de Santa Cruz do Sul, Programa de Pós-Graduação em Promoção da Saúde, Santa Cruz do Sul, RS, Brasil
5Secretaria Estadual da Saúde do Rio Grande do Sul, Hospital Sanatório Partenon, Porto Alegre, RS, Brasil
6Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil
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.
OBJECTIVES 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.
FINDINGS 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).
MAIN 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.
Financial support: PPSUS-FAPERGS/MS/CNPq/SESRS (grant nº 1257-2551/13-8).
Received 3 August 2016
Accepted 15 December 2016