Factors Influencing the Development of Extra-Pulmonary Tuberculosis in Patients with Viral Hepatitis Complicated by Pulmonary Tuberculosis

Lingjun SHEN; Longfen LI; Chunjing SHI; Wenming LI; Yuanqing HUANG; Huajie ZHANG; Yun LUO; Jie LI; Li LIU

doi:10.12259/j.issn.2095-610X.S20250215

Volume 46 Issue 2

Feb. 2025

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Lingjun SHEN, Longfen LI, Chunjing SHI, Wenming LI, Yuanqing HUANG, Huajie ZHANG, Yun LUO, Jie LI, Li LIU. Factors Influencing the Development of Extra-Pulmonary Tuberculosis in Patients with Viral Hepatitis Complicated by Pulmonary Tuberculosis[J]. Journal of Kunming Medical University, 2025, 46(2): 103-109. doi: 10.12259/j.issn.2095-610X.S20250215

Citation:

Lingjun SHEN, Longfen LI, Chunjing SHI, Wenming LI, Yuanqing HUANG, Huajie ZHANG, Yun LUO, Jie LI, Li LIU. Factors Influencing the Development of Extra-Pulmonary Tuberculosis in Patients with Viral Hepatitis Complicated by Pulmonary Tuberculosis[J]. Journal of Kunming Medical University, 2025, 46(2): 103-109. doi: 10.12259/j.issn.2095-610X.S20250215

Citation:

Lingjun SHEN, Longfen LI, Chunjing SHI, Wenming LI, Yuanqing HUANG, Huajie ZHANG, Yun LUO, Jie LI, Li LIU. Factors Influencing the Development of Extra-Pulmonary Tuberculosis in Patients with Viral Hepatitis Complicated by Pulmonary Tuberculosis[J]. Journal of Kunming Medical University, 2025, 46(2): 103-109. doi: 10.12259/j.issn.2095-610X.S20250215

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Factors Influencing the Development of Extra-Pulmonary Tuberculosis in Patients with Viral Hepatitis Complicated by Pulmonary Tuberculosis

doi: 10.12259/j.issn.2095-610X.S20250215

1.
Department of Comprehensive Tuberculosis
2.
Health Examination Center
3.
Department of Hepatology，Kunming Third People’s Hospital/Yunnan Provincial Clinical Center for Infectious Diseases，Kunming Yunnan 650041，China

Received Date: 2024-08-30
Available Online: 2025-01-04
Publish Date: 2025-02-18

Abstract

Abstract

Objective To investigate the factors influencing the development of extra-pulmonary tuberculosis （EPTB） in patients with viral hepatitis complicated by pulmonary tuberculosis（PTB）. Methods A retrospective analysis was conducted on 427 patients with Hepatitis B Virus （HBV） and Hepatitis C Virus （HCV） infections complicated by PTB admitted to the tuberculosis department of Kunming Third People’ s Hospital from January 2015 to December 2020. Patients were divided into the EPTB complication group （n = 72） and the non-EPTB complication group （n = 355） based on the presence of EPTB.Clinical treatment data of patients were collected. Univariate and multivariate Logistic regression analyse were used to screen independent risk factors for EPTB as predictive factors. A nomogram prediction model was established for Extrapulmonary Tuberculosis （EPTB） complications in patients with viral hepatitis and Pulmonary Tuberculosis （PTB） , evaluated using the Hosmer-Lemeshow test and ROC curve analysis. Results Among the 427 patients, 292 （68.3%） were male and 135 （31.7%） were female, with 72 cases of EPTB, resulting in an incidence rate of 16.86%. In the EPTB group, there were 34 males （47.2%） and 38 females （52.8%）. The types of EPTB included tuberculous pleuritis （21 cases, 29%）, tuberculous peritonitis（16 cases, 22%）, lymph node tuberculosis （13 cases, 18%）, tuberculous encephalitis（5 cases, 6%）, intestinal tuberculosis（ 6 cases, 8%）, bone tuberculosis（5 cases, 6%）, pelvic tuberculosis（3 cases, 4%）, and genitourinary tuberculosis（3 cases, 4%）. Multivariate logistic regression analysis showed that gender （OR = 0.425, 95%CI: 0.250-0.722, P = 0.02）, low triglyceride （TG） levels （OR = 0.837, 95%CI: 0.717-0.978, P = 0.025）, the tuberculosis-specific antigen A （ESAT-6）（OR = 1.007, 95%CI: 1.003 ～ 1.011 were independent influencing factors for EPTB in patients with PTB complicated by HBV and HCV infections. The optimal cutoff value for the nomogram model is 0.192, with a sensitivity of 0.611, specificity of 0.710, Youden index of 0.741, positive likelihood ratio of 2.103, and negative likelihood ratio of 0.548. The Hosmer-Lemeshow test yielded χ² = 2.631, P = 0.955. ROC curve analysis showed an AUC of 0.693, 95%CI: 0.6291 ～ 0.7574. Conclusion The prediction model based on gender, low TG levels and ESAT-6 can well predict the occurrence of EPTB to some extent, providing a reference for clinical treatment.
- Viral hepatitis,
- Pulmonary tuberculosis,
- Extra-pulmonary tuberculosis,
- Influencing factor

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References

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