P63 The prevalence of viral hepatitis in patients undergoing anti-tuberculous therapy

Abstract

Background: One-third of the world's population is thought to be infected with Mycobacterium tuberculosis (Mtb); the highest incidence rates for active disease are found in the WHO's South-East Asian and African regions. Hepatitis B virus (HBV) and Hepatitis C virus (HCV) each infect about 0.3{%} of the UK population. HBV/ HCV are treatable but largely asymptomatic until advanced liver disease and/or cancer. Screening for HBV/HCV is recommended in high-risk individuals but is not routinely performed in TB patients. HBV/HCV share similar epidemiological “hotspots” to TB, and several studies, primarily in South America and East Asia, have shown an increased prevalence of HBV/HCV in TB patients and an association between HBV/HCV and Drug Induced Liver Injury (DILI) following anti-TB therapy. No such analysis has been performed in the UK. Aims To assess 1. The prevalence of markers of HBV and HCV infection in patients undergoing anti-TB therapy. 2. Whether serological evidence of HBV/HCV increases risk of DILI. Method A prospective study on 429 TB patients receiving anti-TB therapy in a diverse urban TB clinic. Serological markers of HBV/ HCV/HIV infection were documented. ALT was measured prior to treatment and 2-4 weeks after treatment initiation. DILI was defined as an ALT rise of greater than 2-times upper limit of normal following a normal pre-treatment level ({