HBV coinfection among TB patients higher than expected

Coinfection with hepatitis B virus (HBV) among patients with tuberculosis (TB) appears to be 38-percent to 450-percent more prevalent than published estimates from the Polaris group of region-specific overall HBV prevalence, suggest the results of a meta-analysis.

A team of investigators performed a systematic review of literature using the database of PubMed from inception through 1 September 2019 and identified studies providing data to calculate HBV coinfection prevalence among TB patients. They stratified prevalence estimates of HBV coinfection among adults with TB by world regions and calculated these using meta-analyses with random-effects models.

Thirty-six studies were eligible for meta-analysis: four from the Africa region, six from the Americas, five from Eastern Mediterranean, two from Europe, six from Southeast Asia, and 13 from Western Pacific.

Overall, the pooled prevalence of HBV coinfection among TB patients was 7.1 percent, but this varied by world region. Africa showed the highest region-specific pooled HBV coinfection among adults with TB at 11.4 percent (95 percent confidence interval [CI], 3.45‒19.31), followed by Western Pacific at 10.8 percent (95 percent CI, 8.68‒12.84), while the Americas recorded the lowest prevalence at 2.2 percent (95 percent CI, 0.78‒3.53).

Similar estimates of HBV prevalence across world regions were seen in sensitivity analyses.

“Timely identification of HBV infection among TB patients will improve patient outcomes by allowing for closer clinical monitoring and management, which may reduce the risk of liver dysfunction and liver failure related to TB treatment,” the investigators said.