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

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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.

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

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

Received Date: 2024-08-30

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(25)

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