Co-administration of treatment for drug-resistant tuberculosis and hepatitis C: rapid communication
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World Health Organization
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5 p.
This rapid communication summarizes the evidence and key implications for the co-administration of treatment for drug-resistant tuberculosis (MDR/RR-TB) and chronic hepatitis C virus (HCV) infection. Developed to inform national tuberculosis programmes and other stakeholders, it addresses the clinical and programmatic management of patients with co-infection in the context of limited published evidence. The document describes the public health rationale for integrated treatment, outlines the overlap between MDR/RR-TB and HCV epidemiology, and presents findings from a systematic review complemented by expert evidence collected from clinicians across multiple countries and assessed using the GRADE approach. The available evidence, although of very low certainty, suggests that concomitant treatment for MDR/RR-TB and HCV is feasible and may improve treatment success while reducing treatment failure, loss to follow-up and mortality compared with delaying HCV therapy until completion of tuberculosis treatment. The communication indicates that co-administration should be guided by consideration of potential drug–drug interactions, patient preferences and WHO-recommended standards for patient-centred care, safety monitoring and clinical follow-up. It also outlines planned incorporation of these findings into updated WHO tuberculosis treatment guidelines and operational guidance.
This rapid communication summarizes the evidence and key implications for the co-administration of treatment for drug-resistant tuberculosis (MDR/RR-TB) and chronic hepatitis C virus (HCV) infection. Developed to inform national tuberculosis programmes and other stakeholders, it addresses the clinical and programmatic management of patients with co-infection in the context of limited published evidence. The document describes the public health rationale for integrated treatment, outlines the overlap between MDR/RR-TB and HCV epidemiology, and presents findings from a systematic review complemented by expert evidence collected from clinicians across multiple countries and assessed using the GRADE approach. The available evidence, although of very low certainty, suggests that concomitant treatment for MDR/RR-TB and HCV is feasible and may improve treatment success while reducing treatment failure, loss to follow-up and mortality compared with delaying HCV therapy until completion of tuberculosis treatment. The communication indicates that co-administration should be guided by consideration of potential drug–drug interactions, patient preferences and WHO-recommended standards for patient-centred care, safety monitoring and clinical follow-up. It also outlines planned incorporation of these findings into updated WHO tuberculosis treatment guidelines and operational guidance.