Naderi Malihe, Hosseini Seyed Masoud, Soltani Seyed Amir, Hamidi Sofiani Vahideh, Moradi Abdolvahab
Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Hiroshima, Japan.
Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran.
SAGE Open Med. 2025 Sep 17;13:20503121251376150. doi: 10.1177/20503121251376150. eCollection 2025.
Viral hepatitis and tuberculosis are major public health concerns with shared risk factors, especially in marginalized communities. Despite this, routine hepatitis B and C viruses screening in tuberculosis patients is uncommon. This study, conducted in Golestan Province, where tuberculosis and hepatitis B virus have high incidence rates, aimed to assess the rates and prevalence of hepatitis B and anti-hepatitis C viruses testing among active tuberculosis patients.
Our cross-sectional study was conducted between March 2018 and March 2023 and included patient records of 2283 tuberculosis cases registered in the database of Golestan University of Medical Sciences. Hepatitis B and anti-hepatitis C viruses were tested among patients with confirmed tuberculosis. Clinical and demographic data were collected by taking patient records and performing structured interviews. Exclusions were limited to patients with a confirmed tuberculosis diagnosis. Patients who did not consent to participate and had incomplete information were excluded from the study.
Among 2280 tuberculosis patients, 50.1% were male, with a mean age of 46.22 years. Hepatitis B virus surface antigen was detected in 10.57%, and 2.32% tested positive for anti-hepatitis C virus antibodies. Men were more frequently tested for anti-hepatitis C virus positivity than women (62.15% versus 37.85%, > 0.3). Most co-infected patients resided in rural areas, with pulmonary tuberculosis being the predominant manifestation. Co-infection rates among chronic hepatitis B virus patients varied by family structure: 6.7% in three-generation families, 15% in two-generation families, and 15% in intrafamilial cases. Additionally, 20% of mother-child pairs and 7.5% of intrafamilial hepatitis B virus patients tested positive for anti-hepatitis C virus. Liver function test abnormalities were more common in hepatitis B virus and tuberculosis patients, especially in hepatitis B/anti-hepatitis C viruses positive tuberculosis cases ( = 0.05). Hepatitis B virus DNA levels were higher in CHB/tuberculosis patients compared to CHB-only patients ( = 0.02).
Tuberculosis patients were more likely to test positive for hepatitis B and anti-hepatitis C viruses than the general population. These results emphasize the need for regular screening and coordinated care for co-infected patients.
病毒性肝炎和结核病是主要的公共卫生问题，存在共同的风险因素，尤其是在边缘化社区。尽管如此，对结核病患者进行常规的乙型和丙型肝炎病毒筛查并不常见。本研究在结核病和乙型肝炎病毒发病率较高的戈勒斯坦省进行，旨在评估活动性结核病患者中乙型肝炎和抗丙型肝炎病毒检测的比例和流行情况。
我们的横断面研究于2018年3月至2023年3月进行，纳入了戈勒斯坦医科大学数据库中登记的2283例结核病病例的患者记录。对确诊为结核病的患者进行乙型肝炎和抗丙型肝炎病毒检测。通过获取患者记录和进行结构化访谈收集临床和人口统计学数据。排除仅限于确诊为结核病的患者。不同意参与和信息不完整的患者被排除在研究之外。
在2280例结核病患者中，50.1%为男性，平均年龄为46.22岁。10.57%的患者检测出乙型肝炎病毒表面抗原，2.32%的患者抗丙型肝炎病毒抗体检测呈阳性。男性抗丙型肝炎病毒阳性检测率高于女性（62.15%对37.85%，>0.3）。大多数合并感染患者居住在农村地区，肺结核是主要表现形式。慢性乙型肝炎病毒患者的合并感染率因家庭结构而异：三代家庭为6.7%，二代家庭为15%，家庭内病例为15%。此外，20%的母婴对和7.5%的家庭内乙型肝炎病毒患者抗丙型肝炎病毒检测呈阳性。肝功能检查异常在乙型肝炎病毒和结核病患者中更为常见，尤其是在乙型肝炎/抗丙型肝炎病毒阳性的结核病病例中（=0.05）。与仅患慢性乙型肝炎的患者相比，慢性乙型肝炎/结核病患者的乙型肝炎病毒DNA水平更高（=0.02）。
结核病患者乙型肝炎和抗丙型肝炎病毒检测呈阳性的可能性高于一般人群。这些结果强调了对合并感染患者进行定期筛查和协调护理的必要性。
