Effects of Duration of Treatment, HIV and HCV Co-Infection on Hematological and Hepatic Functions in Libyan Patients with Pulmonary Tuberculosis

Background: Pulmonary tuberculosis (TB) remains a major global health problem despite the availability of efficient treatment over the last decades. TB is the most common opportunistic infection among HIV patients and complicated the outcome of treatment globally. Aims: The prevalence of HCV infection among TB patients has not fully been investigated and limited data on rates of HCV co-infection in TB patients exist. Therefore, this study was aimed to investigate the effects of duration of treatment with first line anti-TB drug, HIV, HCV and co-infection on haematological and hepatic functions in Libyan patients with pulmonary TB. Methods: A total of 120 Libyan newly diagnosed pulmonary TB patients (74 males and 46 females) with age range of 26 to 41 years old were enrolled in this study. They were selected for a regular follow up on the basis of inclusion and exclusion criteria. Pulmonary TB was confirmed by chest X-ray and sputum smear in all the patients. Patients were divided into three groups; the first group of 75 patients with no HIV and HCV infections (positive control), the second group of 35 patients who had TB and HIV co-infection, before starting anti-microbial therapy, while the third group consists of 20 patients who had TB and HCV co-infection before starting anti-HCV treatment. All patients received a confirmation of the 1st line anti-TB drug (isoniazid, rifampin, ethambutol and pyrazinamide for five consecutive weeks) simultaneously.Results: The results showed a significant decrease in white blood cells (WBCs) in all the groups of patients and significant changes in other haematological parameters, there were also significant increases in the hepatic enzyme activities, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP), in all the groups which indicate hepatic toxicity.Conclusion: Treatment with first line anti-TB drug simultaneously produced hepatotoxicity after two weeks which is more in HIV and HCV co-infection patients.