Abstract

Liver and kidney toxicities are major concerns in tuberculosis (TB) patients due to drug treatments. This study investigated the frequencies and toxicities of HIV, Hepatitis B Virus (HBV), and COVID-19 co-infections in pulmonary TB patients. A prospective cohort study (September 2022-December 2023) at Jamot Hospital, Yaoundé, included 300 TB patients with sputum, blood, and nasopharyngeal samples collected. Serological analyses for HIV, COVID-19, and HBV were performed using immunochromatography. Biochemical parameters (AST, ALT, ALP, total bilirubin, urea, and creatinine) were measured using kinetic and colorimetric methods, alongside Glomerular Filtration Rate (GFR) estimation. The study found 69.3% mono-TB cases and co-infection rates of 17.7% (TB/HIV), 9.7% (TB/HBV), 0.7% (TB/COVID-19), 2.3% (TB/HIV/HBV), and 0.3% (TB/HIV/COVID-19). Elevated ALT (95.86±53.53 U/L) and bilirubin (18.70±23.77 mg/dL) were significant in TB/HIV/HBV patients, while ALP (510.88±440.90 U/L) was higher in TB/HIV/COVID-19 patients. Over time, significant toxicities included elevated ALT in TB/COVID-19 (day 90), ALP in TB/HBV (day 90), bilirubin in TB/HIV (day 90), creatinine in TB/HBV (day 180), and glomerular filtration rates in mono-TB patients (day 180). These findings highlight the high prevalence of co-infections and their association with liver and kidney toxicities. The study underscores the need for better monitoring and management of co-infected TB patients to improve treatment outcomes.

Key words: Pulmonary tuberculosis, co-infections (TB and HIV, COVID-19, HBV), toxicity, Jamot Hospital, Cameroon.