Robert J Wong1,2, Amit S Chitnis3, Jennie Chen3,4, Ashley Hubbard5, Laurie Bagley5,6, Rita Shiau7. 1. Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Healthcare System, 3801 Miranda Ave., Palo Alto, CA, 94304, USA. Rwong123@stanford.edu. 2. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 420 Broadway Street, Pavilion D, 2nd Floor, Redwood City, CA, 94063, USA. Rwong123@stanford.edu. 3. Tuberculosis Section, Division of Communicable Disease Control and Prevention, Alameda County Public Health Department, 1000 San Leandro Blvd., San Leandro, CA, 94577, USA. 4. California Department of Public Health Preventive Medicine Residency Program, MS-7213, P.O. Box 997377, Sacramento, CA, 95899, USA. 5. Department of Medicine, Alameda Health System, Highland Hospital, 1411 East 31st St., Oakland, CA, 94602, USA. 6. Medical Library Services, Alameda Health System, 1411 East 31st St., Oakland, CA, 94602, USA. 7. Department of Family and Community Medicine - UCSF, 995 Potrero Ave., San Francisco, CA, 94110, USA.
Abstract
BACKGROUND: Tuberculosis (TB) and chronic hepatitis B virus infection (HBV) can be prevented through latent tuberculosis infection (LTBI) treatment and HBV vaccination, respectively. Prevalence of LTBI and HBV are six- and ninefold higher among non-US-born compared to US-born persons, respectively. Few studies have described the prevalence of LTBI-HBV co-infection. AIMS: In this study, we estimated LTBI prevalence among persons with chronic HBV. METHODS: We conducted a systematic review and meta-analysis using PubMed from inception through September 1, 2019, and identified and reviewed studies that provided data regarding LTBI prevalence among adults with chronic HBV. Pooled LTBI prevalence among adults with HBV was calculated using a random-effects meta-analysis model. RESULTS: A total of 1,205 articles were identified by systematic review of the published literature. Six studies were included in the meta-analysis; five studies were conducted in North America, and one was in China. LTBI prevalence among adults with chronic HBV was estimated to be 34.25% (95% confidence interval: 17.88-50.62%). CONCLUSION: LTBI prevalence among adults with chronic HBV was two times higher than the LTBI prevalence among all non-US-born persons. The high LTBI prevalence and increased risk of hepatotoxicity with TB medications among persons with chronic HBV may warrant consideration of routine screening for HBV among persons who are tested for LTBI. Reducing morbidity and mortality associated with TB and chronic HBV may require healthcare systems and public health to ensure that persons at risk of both infections are screened and treated for LTBI and chronic HBV.
BACKGROUND: Tuberculosis (TB) and chronic hepatitis B virus infection (HBV) can be prevented through latent tuberculosis infection (LTBI) treatment and HBV vaccination, respectively. Prevalence of LTBI and HBV are six- and ninefold higher among non-US-born compared to US-born persons, respectively. Few studies have described the prevalence of LTBI-HBV co-infection. AIMS: In this study, we estimated LTBI prevalence among persons with chronic HBV. METHODS: We conducted a systematic review and meta-analysis using PubMed from inception through September 1, 2019, and identified and reviewed studies that provided data regarding LTBI prevalence among adults with chronic HBV. Pooled LTBI prevalence among adults with HBV was calculated using a random-effects meta-analysis model. RESULTS: A total of 1,205 articles were identified by systematic review of the published literature. Six studies were included in the meta-analysis; five studies were conducted in North America, and one was in China. LTBI prevalence among adults with chronic HBV was estimated to be 34.25% (95% confidence interval: 17.88-50.62%). CONCLUSION: LTBI prevalence among adults with chronic HBV was two times higher than the LTBI prevalence among all non-US-born persons. The high LTBI prevalence and increased risk of hepatotoxicity with TB medications among persons with chronic HBV may warrant consideration of routine screening for HBV among persons who are tested for LTBI. Reducing morbidity and mortality associated with TB and chronic HBV may require healthcare systems and public health to ensure that persons at risk of both infections are screened and treated for LTBI and chronic HBV.
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