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Prevalence of Latent Tuberculosis Infection Among Persons with Chronic Hepatitis B Virus Infection: A Systematic Review and Meta-Analysis

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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.

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Funding

The authors report no financial or grand support for this project.

Author information

Author notes

  1. Robert J. Wong and Amit S. Chitnis have contributed equally to this work.

Authors and Affiliations

  1. Tuberculosis Section, Division of Communicable Disease Control and Prevention, Alameda County Public Health Department, 1000 San Leandro Blvd., San Leandro, CA, 94577, USA

    Jennie Chen & Amit S. Chitnis

  2. California Department of Public Health Preventive Medicine Residency Program, MS-7213, P.O. Box 997377, Sacramento, CA, 95899, USA

    Jennie Chen

  3. Department of Medicine, Alameda Health System, Highland Hospital, 1411 East 31st St., Oakland, CA, 94602, USA

    Ashley Hubbard & Laurie Bagley

  4. Medical Library Services, Alameda Health System, 1411 East 31st St., Oakland, CA, 94602, USA

    Laurie Bagley

  5. Department of Family and Community Medicine - UCSF, 995 Potrero Ave., San Francisco, CA, 94110, USA

    Rita Shiau

  6. Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Healthcare System, 3801 Miranda Ave., Palo Alto, CA, 94304, USA

    Robert J. Wong

  7. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 420 Broadway Street, Pavilion D, 2nd Floor, Redwood City, CA, 94063, USA

    Robert J. Wong

Authors
  1. Jennie Chen
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Contributions

AH, LB, RS, RJW, and ASC were involved in study concept and design. AH, LB, RS, RJW, and ASC were involved in acquisition of data. JC, AH, LB, RS, RJW, and ASC were involved in analysis and interpretation of data. RJW was involved in statistical analysis. JC, RJW, and ASC were involved in drafting of the manuscript. JC, AH, LB, RS, RJW, and ASC were involved in critical revision of the manuscript for important intellectual content. RJW and ASC were involved in study supervision. Drs. RJW and ASC had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis.

Corresponding author

Correspondence to Robert J. Wong.

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Conflict of interest

Jennie Chen: None, Ashley Hubbard: None, Laurie Bagley: None, Rita Shiau: None, Robert J. Wong: Advisory board, consultant, and research grants – Gilead Sciences. Amit S. Chitnis: None.

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Chen, J., Hubbard, A., Bagley, L. et al. Prevalence of Latent Tuberculosis Infection Among Persons with Chronic Hepatitis B Virus Infection: A Systematic Review and Meta-Analysis. Dig Dis Sci 67, 2646–2654 (2022). https://doi.org/10.1007/s10620-021-07056-5

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  • DOI: https://doi.org/10.1007/s10620-021-07056-5

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