Limits...
Incidence rates of tuberculosis in chronic hepatitis C infected patients with or without interferon based therapy: a population-based cohort study in Taiwan.

Lin SY, Chen TC, Lu PL, Lin CY, Lin WR, Yang YH, Chen YH - BMC Infect. Dis. (2014)

Bottom Line: Although some case reports have demonstrated a possible association, the results are currently inconclusive.There was no significant difference in the incidence of active TB in either cohort during a 1-year follow-up (Adjusted Hazard Ratio (AHR): 2.81, 95% Confidence Interval (95% CI): 0.61-12.98) or the long-term follow-up (AHR: 1.02, 95% CI: 0.28-3.78).Our results showed that IBT is associated with increased hazard of active TB in HCV infected patients in 1-year follow-up; however, the effect sizes were not statistically significant.

View Article: PubMed Central - PubMed

Affiliation: Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. amoe616@gmail.com.

ABSTRACT

Background: It is debated whether interferon-based therapy (IBT) would affect the incidence of active tuberculosis (TB) among hepatitis C virus (HCV) infected patients. Although some case reports have demonstrated a possible association, the results are currently inconclusive. Therefore, we conducted a nation-wide population study to investigate the incidence of active TB in HCV infected patients receiving IBT in Taiwan.

Methods: This 9-year cohort study was based on the Longitudinal Health Insurance Database 2000 (LHID 2000) consisting of 1,000,000 beneficiaries randomly selected from all Taiwan National Health Insurance enrollees in 2000 ( >23.7 million). This insurance program covers all citizens in Taiwan. We conducted a retrospective cohort study that identified subjects with HCV infection. IBTs were defined as regimens that included interferon α, peginterferon α2a and peginterferon α2b for at least 2 months. Among them, 621 subjects received IBT, and 2,460 age- and gender-matched subjects were enrolled for analysis. The Cox proportional hazards models were used to estimate the hazard ratio (HR) for active TB, and associated confidence intervals (CIs), comparing IBT cohort and untreated cohort. The endpoint in this study was whether an enrolled subject had a new diagnosis of active TB.

Results: During the 9-year enrollment period, the treated and untreated cohorts were followed for a mean (± SD) duration of 6.97 ± 0.02 years and 8.21 ± 0.01 years, respectively. The cumulative incidence rate of active TB during this study period was 0.150 and 0.151 per 100 person-years in the IBT treated and untreated cohorts, respectively. There was no significant difference in the incidence of active TB in either cohort during a 1-year follow-up (Adjusted Hazard Ratio (AHR): 2.81, 95% Confidence Interval (95% CI): 0.61-12.98) or the long-term follow-up (AHR: 1.02, 95% CI: 0.28-3.78). The Cox proportional hazards model demonstrated that IBT was not a risk factor for active TB . The only risk factor for active TB was the occurrence of hepatic encephalopathy.

Conclusion: Our results showed that IBT is associated with increased hazard of active TB in HCV infected patients in 1-year follow-up; however, the effect sizes were not statistically significant.

Show MeSH

Related in: MedlinePlus

1 minus Kaplan Meier to approximate cumulative incidence of tuberculosis among the IBT cohort (treated) and the untreated cohort (untreated) during 1-year follow-up (log rank test: 1.26,P = 0.261).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4307221&req=5

Fig2: 1 minus Kaplan Meier to approximate cumulative incidence of tuberculosis among the IBT cohort (treated) and the untreated cohort (untreated) during 1-year follow-up (log rank test: 1.26,P = 0.261).

Mentions: During the 9-year enrollment period, the treated and untreated cohorts were followed up for a mean (± SD) duration of 6.97 ± 0.02 years and 8.21 ± 0.01 years, respectively. Among the treated cohort, which included those who had ever received IBT for a minimum of 8 weeks, the mean (± SD) duration of the antiviral regimen was 20.29 ± 4.50 weeks. During a 1-year follow-up, 3 patients developed TB in IBT treated cohort and 5 patients developed TB in untreated cohort. During the long-term follow-up, 3 patients developed TB in IBT- treated cohort and 12 patients developed TB in untreated cohort. The cumulative incidences of TB during this study period were 0.150 and 0.151 per 100 person-years in the IBT treated and untreated cohorts in long-term follow-up, respectively. There was no significant difference in the incidence of active TB in either cohort during a 1-year follow-up (Adjusted Hazard Ratio (AHR): 2.81, 95% Confidence Interval (95% CI): 0.61–12.98) or the long-term follow-up (AHR: 1.02, 95% CI: 0.28 – 3.78) (Table 2). Further analysis by the log-rank test revealed no significant difference of the incidence of TB in both cohorts during 1-year and long-term follow-up periods.(P = 0.261 and 0.987, respectively) Figure 2 showed the crude cumulative incidence of tuberculosis among both cohorts in 1-year follow-up.Table 2


Incidence rates of tuberculosis in chronic hepatitis C infected patients with or without interferon based therapy: a population-based cohort study in Taiwan.

Lin SY, Chen TC, Lu PL, Lin CY, Lin WR, Yang YH, Chen YH - BMC Infect. Dis. (2014)

1 minus Kaplan Meier to approximate cumulative incidence of tuberculosis among the IBT cohort (treated) and the untreated cohort (untreated) during 1-year follow-up (log rank test: 1.26,P = 0.261).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4307221&req=5

Fig2: 1 minus Kaplan Meier to approximate cumulative incidence of tuberculosis among the IBT cohort (treated) and the untreated cohort (untreated) during 1-year follow-up (log rank test: 1.26,P = 0.261).
Mentions: During the 9-year enrollment period, the treated and untreated cohorts were followed up for a mean (± SD) duration of 6.97 ± 0.02 years and 8.21 ± 0.01 years, respectively. Among the treated cohort, which included those who had ever received IBT for a minimum of 8 weeks, the mean (± SD) duration of the antiviral regimen was 20.29 ± 4.50 weeks. During a 1-year follow-up, 3 patients developed TB in IBT treated cohort and 5 patients developed TB in untreated cohort. During the long-term follow-up, 3 patients developed TB in IBT- treated cohort and 12 patients developed TB in untreated cohort. The cumulative incidences of TB during this study period were 0.150 and 0.151 per 100 person-years in the IBT treated and untreated cohorts in long-term follow-up, respectively. There was no significant difference in the incidence of active TB in either cohort during a 1-year follow-up (Adjusted Hazard Ratio (AHR): 2.81, 95% Confidence Interval (95% CI): 0.61–12.98) or the long-term follow-up (AHR: 1.02, 95% CI: 0.28 – 3.78) (Table 2). Further analysis by the log-rank test revealed no significant difference of the incidence of TB in both cohorts during 1-year and long-term follow-up periods.(P = 0.261 and 0.987, respectively) Figure 2 showed the crude cumulative incidence of tuberculosis among both cohorts in 1-year follow-up.Table 2

Bottom Line: Although some case reports have demonstrated a possible association, the results are currently inconclusive.There was no significant difference in the incidence of active TB in either cohort during a 1-year follow-up (Adjusted Hazard Ratio (AHR): 2.81, 95% Confidence Interval (95% CI): 0.61-12.98) or the long-term follow-up (AHR: 1.02, 95% CI: 0.28-3.78).Our results showed that IBT is associated with increased hazard of active TB in HCV infected patients in 1-year follow-up; however, the effect sizes were not statistically significant.

View Article: PubMed Central - PubMed

Affiliation: Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. amoe616@gmail.com.

ABSTRACT

Background: It is debated whether interferon-based therapy (IBT) would affect the incidence of active tuberculosis (TB) among hepatitis C virus (HCV) infected patients. Although some case reports have demonstrated a possible association, the results are currently inconclusive. Therefore, we conducted a nation-wide population study to investigate the incidence of active TB in HCV infected patients receiving IBT in Taiwan.

Methods: This 9-year cohort study was based on the Longitudinal Health Insurance Database 2000 (LHID 2000) consisting of 1,000,000 beneficiaries randomly selected from all Taiwan National Health Insurance enrollees in 2000 ( >23.7 million). This insurance program covers all citizens in Taiwan. We conducted a retrospective cohort study that identified subjects with HCV infection. IBTs were defined as regimens that included interferon α, peginterferon α2a and peginterferon α2b for at least 2 months. Among them, 621 subjects received IBT, and 2,460 age- and gender-matched subjects were enrolled for analysis. The Cox proportional hazards models were used to estimate the hazard ratio (HR) for active TB, and associated confidence intervals (CIs), comparing IBT cohort and untreated cohort. The endpoint in this study was whether an enrolled subject had a new diagnosis of active TB.

Results: During the 9-year enrollment period, the treated and untreated cohorts were followed for a mean (± SD) duration of 6.97 ± 0.02 years and 8.21 ± 0.01 years, respectively. The cumulative incidence rate of active TB during this study period was 0.150 and 0.151 per 100 person-years in the IBT treated and untreated cohorts, respectively. There was no significant difference in the incidence of active TB in either cohort during a 1-year follow-up (Adjusted Hazard Ratio (AHR): 2.81, 95% Confidence Interval (95% CI): 0.61-12.98) or the long-term follow-up (AHR: 1.02, 95% CI: 0.28-3.78). The Cox proportional hazards model demonstrated that IBT was not a risk factor for active TB . The only risk factor for active TB was the occurrence of hepatic encephalopathy.

Conclusion: Our results showed that IBT is associated with increased hazard of active TB in HCV infected patients in 1-year follow-up; however, the effect sizes were not statistically significant.

Show MeSH
Related in: MedlinePlus