High prevalence of hepatitis C infection among multidrug-resistant tuberculosis patients
Authors: Kwonjune J. Seung, Molly F. Franke, Catherine Hewison, Helena Huerga, Uzma Khan, Carole D. Mitnick, on behalf of the endTB Study Group
To the Editor:
In “Integrating HCV testing with HIV programs improves hepatitis C outcomes in people who inject drugs: A cluster-randomized trial”, the authors studied an intervention that integrated HCV testing and education into HIV services across India. In our opinion, many national tuberculosis (TB) programs should also consider integrating HCV testing. TB or the highly resistant variant of the disease, multidrug-resistant (MDR) TB, is generally not considered a risk factor for HBV or HCV infection, except in those who are co-infected with HIV or who are intravenous drug users. Routine, systematic testing for HCV is rare in patients with MDR-TB and is not currently recommended in World Health Organization guidelines for MDR-TB treatment.
The endTB Observational Study (NCT02754765) is a study of patients receiving a bedaquiline- or delamanid-containing regimen for rifampicin-resistant/MDR-TB at sites in 17 countries: Armenia, Bangladesh, Belarus, Democratic People's Republic of North Korea, Ethiopia, Kenya, Georgia, Haiti, Indonesia, Kazakhstan, Kyrgyzstan, Lesotho, Myanmar, Pakistan, Peru, South Africa, Vietnam.[2] Patients were eligible for inclusion if they received a regimen containing either bedaquiline or delamanid at an endTB site and provided informed consent to allow their clinical data to be analyzed. A study protocol guided data collection, but not treatment, across sites. During the study time period, patients were generally treated with bedaquiline or delamanid when a regimen of at least 4 likely effective drugs could not be constructed due to resistance or toxicity. Most patients received longer individualized treatment regimens according to national TB program guidelines.
Access to the full text - https://doi.org/10.1016/j.jhep.2019.10.018
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