الفهرس 
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Abstract
Tuberculosis and hepatitis C virus remain major health problems in our country that affect health, economy and development. Tuberculosis remains a leading health problem in both developing and developed countries. The prevalence of TB was reported to be higher among HCV-infected patients than among those without.
Several studies were done to show the correlation between TB and HCV co- infection and its effect on patients.
The present study aimed to assess the effect of hepatitis c virus infection on the course and outcome of patients with pulmonary tuberculosis
This study was carried out on a two groups of patients (40 patients) referred to Tanta Chest Hospital during the period from January 2015 to December 2016. group I: 20 patients with pulmonary tuberculosis and sero- positive hepatitis c virus infection.
group II: 20 patients with pulmonary tuberculosis and sero- negative HCV infection as age and sex matched control group.
All cases were examined by: 1- sputum analysis for acid fast bacilli, sputum culture and gene expert for TB diagnosis and for follow up.
2- Liver function test to assess the liver state before, during and after treatment.
3- Chest x ray at diagnosis and follow up.
In the current work, we do comparison between the two studied groups and find that:
There was no significant difference according to type of patient but the number of retreatment cases was higher in group I than group II.
And no significant difference according to patient symptoms, But hemoptysis was more common symptom in group I and chronic cough was more common in group II.
And no significant difference according to the methods of diagnosis and positivity of the first sputum samples by direct smear of AFB but smear negative sputum was higher in group I.
And no significant difference according to conversion of samples but delay of conversion (at 3rd months) of samples was higher in group I. And no significant difference according to the radiological finding but diffuse infiltration and caviary lesion was the predominant finding in group I.
Also there was high significant difference according to treatment regimen, HCV titer, child classification (in group I) and outcome of treatment.
So we concluded that
- Negativity of sputum sample was common in patients with HCV infection and there was delayed of sputum conversion than in patients with sero- negative HCV infection.
- Diffuse infiltration and cavitary lesion was the predominant finding in HCV patients. - Patients with class C Child classification and high HCV titer were more liable to have treatment failure.
- The more unstable or severe liver disease is, the fewer hepatotoxic drugs should be used.
We recommended that:
- All patients with unexplained cough lasting two or more weeks or with unexplained findings suggestive of tuberculosis on chest radiographs should be evaluated for tuberculosis.
- - Tuberculin test should be done as screening for sero positive HCV before starting HCV treatment to avoid complication.
- Clinical monitoring and liver function tests of all patients with pre-existing liver disease should be performed frequently during treatment.
- In patients with advanced liver disease with complications of cirrhosis and signs of liver failure, it may not be possible to use even a single hepatotoxic drug.