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接受治疗的肺结核患者发生病毒性肝炎的危险因素：一项系统评价和荟萃分析。

Risk factors for viral hepatitis in pulmonary tuberculosis patients undergoing treatment: A systematic review and meta-analysis.

作者信息

Ilham Ahmad F, Andini Salsabila R, Afladhia Hanna L, Rakasiwi Muhammad Id, Burhan Erlina

机构信息

Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

Respiratory Programmatic Implementation and Research Institute, Jakarta, Indonesia.

出版信息

Narra J. 2024 Dec;4(3):e1242. doi: 10.52225/narra.v4i3.1242. Epub 2024 Dec 2.

DOI:10.52225/narra.v4i3.1242
PMID:39816129
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11731815/
Abstract

Liver injury in tuberculosis patients, associated with noncompliance with treatment, is further exacerbated by viral hepatitis, which not only directly harms the liver but also increases susceptibility to drug-induced liver injury. The aim of this study was to analyze the associated risk factors for viral hepatitis in tuberculosis patients. This systematic review and meta-analysis adhere to the PRISMA 2020 statement, and the protocol has been registered with PROSPERO (CRD42023477241). Screening and selection of articles were carried out according to predetermined inclusion and exclusion criteria, utilizing four databases: Embase, Medline, Scopus, and ProQuest. Baseline characteristics and patient-related risk factors from each included study were extracted, followed by a meta- analysis of factors that potentially had significance, with the heterogeneities also being analyzed. Of the 21 included studies out of 6,415 identified records, 12 potential risk factors for hepatitis B and 15 for hepatitis C were subjected to meta-analysis. Some key risk factors included for hepatitis B and C were HIV infection (OR: 3.42; 95%CI: 2.19- 5.34 and OR: 6.99; 95%CI: 5.09-9.61, respectively), smoking (OR: 1.55; 95%CI: 1.19-2.02 and OR: 3.06; 95%CI: 1.63-5.75, respectively) and alcohol consumption (OR: 2.38; 95%CI: 1.06-5.37 and OR: 4.32; 95%CI: 2.76-6.78, respectively). Furthermore, meta- analysis indicated that other significant risk factors for hepatitis B and/or C include injecting and non-injecting drug use, multiple sexual partners, tattooing, ear-nose piercing, blood transfusion, dental interventions, homelessness, incarceration, living with prisoners, sexually transmitted diseases, and diabetes mellitus. In conclusion, patients with tuberculosis who have risk factors such as smoking, HIV, or alcohol consumption should be screened for hepatitis B and C to prevent liver injury.

摘要

结核病患者的肝损伤与治疗依从性差有关，而病毒性肝炎会进一步加剧这种损伤，病毒性肝炎不仅会直接损害肝脏，还会增加药物性肝损伤的易感性。本研究的目的是分析结核病患者中病毒性肝炎的相关危险因素。本系统评价和荟萃分析遵循PRISMA 2020声明，方案已在PROSPERO（CRD42023477241）注册。根据预先设定的纳入和排除标准，利用四个数据库（Embase、Medline、Scopus和ProQuest）对文章进行筛选和选择。提取每项纳入研究的基线特征和患者相关危险因素，然后对可能具有显著性的因素进行荟萃分析，并分析异质性。在6415条检索记录中，纳入了21项研究，对12个乙型肝炎潜在危险因素和15个丙型肝炎潜在危险因素进行了荟萃分析。乙型肝炎和丙型肝炎的一些关键危险因素包括艾滋病毒感染（OR分别为：3.42；95%CI：2.19 - 5.34和OR：6.99；95%CI：5.09 - 9.61）、吸烟（OR分别为：1.55；95%CI：1.19 - 2.02和OR：3.06；95%CI：1.63 - 5.75）和饮酒（OR分别为：2.38；95%CI：1.06 - 5.37和OR：4.32；95%CI：2.76 - 6.78）。此外，荟萃分析表明，乙型肝炎和/或丙型肝炎的其他显著危险因素包括注射和非注射吸毒、多个性伴侣、纹身、穿耳洞、输血、牙科干预、无家可归、监禁、与囚犯同住、性传播疾病和糖尿病。总之，有吸烟、艾滋病毒或饮酒等危险因素的结核病患者应筛查乙型肝炎和丙型肝炎，以预防肝损伤。

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