High prevalence of hepatitis B virus in TB patients in Kwara State, Nigeria: a call for informed management

Background: Tuberculosis (TB) and chronic hepatitis B virus (HBV) infections are major global health problems, while there currently limited data on HBV infection among TB patients. This study was conducted to determine the prevalence of HBV in tuberculosis patients and evaluate the effect of anti-tuberculosis drugs and HBV infection on the liver. Methods: Two hundred and fifty-eight samples were collected from TB-positive patients attending selected TB clinics in Kwara State, and 227 patients were followed-up. Participants were assessed at start and after 6 months. Sero-markers for HBV infection was detected using Micropoint 5-panel kit, and liver enzymes were evaluated using Randox Kit following manufacturer’s instructions. Data analysis was done using SPSS Version 22.0. Results: Of the 258 patients recruited, 227 were followed-up, and 24 (10.5%) had detectable HBsAg/HBeAb/HBcAb or HBsAg. A comparison of initial liver enzymes and at 6months showed significant difference (p≤0.00), and no associations were observed between educational background (X ² = 0.425, p=0.547), sex (X ² =0.212, p=0.616) or HBV/TB coinfection. High-risk factors included the use of illicit drugs (OR 95% CI; 2.3, 0.9-5.0), having multiple sexual partners (OR 95% CI; 4.1, 0.9-3.8), having a history of STIs (OR 95% CI; 1.6, 0.7-3.7), and consuming alcohol (OR 95% CI; 1.5, 0.4-4.8). Conclusion: In this study we found 10.5% prevalence of HBV/TB coinfection which may have led to elevated liver enzymes (ALT and AST), while total bilirubin was only affected when it has progressed to liver failure and cirrhosis. Routine HBV screening is recommended before treatment in TB patients.