Khan Amir F, Sajjad Ahsan, Mian Dedaar A, Tariq Muhammad M, Jadoon Usman K, Abbas Muhammad, Shakeel Kinza, Saeed Nadia, Abbas Kiran
Surgery, Abbas Institute of Medical Sciences, Muzaffarabad, PAK.
Surgery, Khyber Teaching Hospital, Peshawar, PAK.
Cureus. 2021 Apr 12;13(4):e14433. doi: 10.7759/cureus.14433.
Background The occurrence of both tuberculosis (TB) and concomitant hepatitis B virus (HBV) is likely to be associated with poor patient outcomes and poor treatment response. Objective To assess whether tuberculosis patients with concomitant hepatitis B virus infection were prone to poorer outcomes and treatment response. Methodology A case-control study was undertaken at the Tuberculosis Centre, DHQ Bagh Azad Kashmir and Pulmonology Department, Lady Reading Hospital, Peshawar, between March 2020 and August 2020. All patients with diagnosed tuberculosis and coinfection with hepatitis B were labeled as the case group while those with only tuberculosis acted as the control. All patients with tuberculosis were managed on a directly observed treatment strategy (DOTS). Non-compliant patients and those without complete data were excluded from the study. All data regarding socio-demographics, laboratory investigations, and clinical characteristics were recorded in a predefined proforma. Patients were considered to have good treatment outcomes when patients completed the treatment or had a negative smear at six months of treatment. The Statistical Package for the Social Sciences (SPSS) version 26 (IBM Corp, Armonk, NY) was used for the data analysis. Results A total of 178 patients were enrolled in the study. It was found that patients with concomitant hepatitis B had significantly poorer outcomes as compared to patients who did not have hepatitis B (<0.001). Similarly, TB and hepatitis B patients were significantly associated with severe tuberculosis (<0.001) and required a higher frequency of retreatment (<0.001). Conclusion Our study reports a strong association between the treatment response of patients with tuberculosis with an added hepatitis B infection. Furthermore, a larger number of patients with hepatitis B had severe tuberculosis as compared to those without hepatitis B.
结核病（TB）与乙型肝炎病毒（HBV）合并感染的发生可能与患者预后不良及治疗反应不佳有关。目的：评估合并乙型肝炎病毒感染的结核病患者是否更容易出现较差的预后和治疗反应。方法：2020年3月至2020年8月期间，在克什米尔巴格阿扎德地区总部医院结核病中心和白沙瓦雷丁夫人医院肺病科进行了一项病例对照研究。所有诊断为结核病且合并乙型肝炎的患者被标记为病例组，而仅患有结核病的患者作为对照组。所有结核病患者均采用直接观察治疗策略（DOTS）进行管理。不符合要求的患者和数据不完整的患者被排除在研究之外。所有关于社会人口统计学、实验室检查和临床特征的数据均记录在预先定义的表格中。当患者完成治疗或在治疗6个月时痰涂片阴性时，认为治疗效果良好。使用社会科学统计软件包（SPSS）26版（IBM公司，纽约州阿蒙克）进行数据分析。结果：共有178名患者纳入研究。发现合并乙型肝炎的患者与未感染乙型肝炎的患者相比，预后明显较差（<0.001）。同样，结核病合并乙型肝炎患者与严重结核病显著相关（<0.001），且需要更高频率的复治（<0.001）。结论：我们的研究报告了结核病合并乙型肝炎感染患者的治疗反应之间存在密切关联。此外，与未感染乙型肝炎的患者相比，更多感染乙型肝炎的患者患有严重结核病。
