Wong Robert J, Rupp Loralee, Lu Mei, Yang Zeyuan, Daida Yihe G, Schmidt Mark, Boscarino Joseph A, Gordon Stuart C, Chitnis Amit S
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA.
Gastroenterology Section, Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA.
J Viral Hepat. 2023 Jun;30(6):512-519. doi: 10.1111/jvh.13823. Epub 2023 Mar 6.
The epidemiology of latent tuberculosis and hepatitis B virus (HBV-LTBI) co-infection among U.S. populations is not well studied. We aim to evaluate LTBI testing patterns and LTBI prevalence among two large U.S. cohorts of adults with chronic HBV (CHB). Adults with CHB in the Chronic Hepatitis Cohort Study (CHeCS) and Veterans Affairs national cohort were included in the analyses. Prevalence of HBV-LTBI co-infection was defined as the number of HBV patients with LTBI divided by the number of HBV patients in a cohort. Multivariable logistic regression evaluated odds of HBV-LTBI co-infection among CHB patients who underwent TB testing. Among 6019 CHB patients in the CHeCS cohort (44% female, 47% Asian), 9.1% were tested for TB, among whom 7.7% had HBV-LTBI co-infection. Among HBV-LTBI co-infected patient, only 16.7% (n = 7) received LTBI treatment, among whom 28.6% (n = 2) developed DILI. Among 12,928 CHB patients in the VA cohort (94% male, 42% African American, 39% non-Hispanic white), 14.7% were tested for TB, among whom 14.5% had HBV-LTBI. Among HBV-LTBI co-infected patient, 18.6% (n = 51) received LTBI treatment, among whom 3.9% (n = 3) developed DILI. Presence of cirrhosis, race/ethnicity, and country of birth were observed to be associated with odds of HBV-LTBI co-infection among CHB patients who received TB testing. In summary, among two large distinct U.S. cohorts of adults with CHB, testing for LTBI was infrequent despite relatively high prevalence of HBV-LTBI co-infection. Moreover, low rates of LTBI treatment were observed among those with HBV-LTBI co-infection.
美国人群中潜伏性结核病与乙型肝炎病毒（HBV-LTBI）合并感染的流行病学情况尚未得到充分研究。我们旨在评估美国两个大型慢性HBV（CHB）成年队列中的LTBI检测模式和LTBI患病率。慢性丙型肝炎队列研究（CHeCS）中的CHB成年患者和退伍军人事务部全国队列被纳入分析。HBV-LTBI合并感染的患病率定义为患有LTBI的HBV患者数量除以队列中HBV患者的数量。多变量逻辑回归评估了接受结核病检测的CHB患者中HBV-LTBI合并感染的几率。在CHeCS队列的6019名CHB患者中（44%为女性，47%为亚洲人），9.1%接受了结核病检测，其中7.7%患有HBV-LTBI合并感染。在HBV-LTBI合并感染患者中，只有16.7%（n = 7）接受了LTBI治疗，其中28.6%（n = 2）发生了药物性肝损伤（DILI）。在退伍军人事务部队列的12928名CHB患者中（94%为男性，42%为非裔美国人，39%为非西班牙裔白人），14.7%接受了结核病检测，其中14.5%患有HBV-LTBI。在HBV-LTBI合并感染患者中，18.6%（n = 51）接受了LTBI治疗，其中3.9%（n = 3）发生了DILI。在接受结核病检测的CHB患者中，观察到肝硬化的存在、种族/族裔和出生国家与HBV-LTBI合并感染的几率相关。总之，在美国两个不同的大型CHB成年队列中，尽管HBV-LTBI合并感染的患病率相对较高，但LTBI检测并不常见。此外，在HBV-LTBI合并感染患者中观察到LTBI治疗率较低。
