The role of social factors on the course of mdr-tb with co-infection with viral hepatitis "C" and "B"

Abstract

Dual infections of multidrug-resistant tuberculosis (MDR-TB) or rifampicin-resistant tuberculosis (RR-TB) and hepatitis C virus (HCV) have resulted in nearly half a million cases of MDR-TB annually worldwide and 71 million people living with HCV. Aim of the study to analyze the features of the course of MDR-TB when combined with viral hepatitis “C” and “B”. We examined 192 MDR-TB patients aged from 20 to 70 years who were undergoing inpatient treatment in the 2-therapeutic department of the Tashkent City Clinical Hospital of Phthisiology and Pulmonology (TCCHPhP) in the city of Tashkent in 2021-2022. It was found that out of 192 patients, 48 (25%) were diagnosed with viral hepatitis. Accordingly, the development included 48 patients with co-infection with MDR-TB and viral hepatitis. Of these, 4 (8.4%) were newly diagnosed patients, 44 (91.6%) were previously treated. The spectrum of viral hepatitis was as follows: 37 patients had viral hepatitis C (77.1%), 5 patients had a combination of viral hepatitis “C” and “B” (10.4%) and 6 had viral hepatitis “B” (12.5%). Among those examined, the social characteristics of the patients played an important role. Thus, the bulk were unemployed—45 (93.8%). Workers and employees account for only 3 (6.2 %) people. 26 people had a criminal record, which accounted for 54.1% of patients. Persons without a fixed place of residence made up 10 (20.8%) patients. Almost all patients had secondary education - 44 (91.6%), 2 (4.2%) patients had higher education. All patients had bad habits: smoking was noted in 34 (70.8%) patients, alcohol abuse - in 10 (20.8%), injecting drugs - 8 (16.6%) and nasvay use - in 4 (8, 4%). Moreover, more than half of the patients had two or three bad habits - 25 (52.1%). In conclusion the study of medical and social characteristics made it possible to establish that patients with MDR/RR tuberculosis in combination with viral hepatitis belong in most cases to a socially maladjusted contingent ( 76.2%) . The presence of bad habits, and in more than half of the cases two or three, as well as the presence of a criminal record (54.1%), persons without a fixed place of residence (20.8 %), alcohol abuse (20.8%), injection drugs use (16.6%) significantly affects the treatment process.