Introduction: The severe forms of hepatitis are caused by hepatitis B and hepatitis C viruses. World health organization estimates that each year, 10 million incident cases of tuberculosis were reported and 1.3 million people died as a result of tuberculosis. Co-infection with hepatitis Band C complicates the tuberculosis treatment outcome and may lead to death. This study was conducted to estimate the prevalence, determinants of hepatitis Band hepatitis C and the survival of tuberculosis patients until drug-induced hepatitis.

Methods and materials: Prospective cohort study design was implemented. The data were collected from September 2016 – May 2019. Epi-info software was used to calculate the sample size giving for an estimated 912 HIV positive tuberculosis patients and 2731 HIV negative tuberculosis patients. Systematic random sampling technique was used to select the study participants. Data were collected using interview, document review, collecting the stool and blood samples. Baseline data were collected before the patient starts DOTS, every week sign of liver toxicity was assessed. Tuberculosis treatment outcome and WHO clinical stage was recorded at the end of 6^th months.  Descriptive statistics were used to estimate the prevalence of hepatitis B, hepatitis C viral infections and their effect on tuberculosis treatment outcomes. Binary logistic regression was used to identify the determinants of hepatitis B and hepatitis C viral infection. Kaplan Meier survival curve was used to estimate the survival of tuberculosis patient until drug-induced hepatitis and Cox regression was used to identify the predictors of drug-induced hepatitis.

Results: A total of 3537 tuberculosis patients were followed. The prevalence of hepatitis B and hepatitis C viral infection among tuberculosis patients was 15.1 % [95% CI: 13.92 % - 16.28 %]. And 17.3 % [95 % CI: 16.06 % - 18.55 %]. Hepatitis B viral infection among tuberculosis patients was associated with problematic alcohol use (AOR: 4.15 [95 % CI; 3.03-5.67]), female (AOR: 13.43 [95 % CI; 9.53 -18.93]), HIV (AOR: 4.95 [95 % CI: 3.97 -6.17]), chronic illness (AOR: 1.64 [95 % CI; 1.2 -2.22]), and intestinal parasitic infection (AOR: 1.68 [95 % CI; 1.29 -2.17]). Hepatitis C viral infection among tuberculosis patients was associated with problematic alcohol use (1.46 [1.06 – 2.01]), female (6.89 [5.25 – 9.04]), HIV (10.26 [8.22 -12.81]), chronic illness (4.91 [3.65 – 6.6]). The incidence density for the sign of liver toxicity among tuberculosis patients was 843/15707 person-months and liver toxicity was determined by HIV, Hepatitis B, Hepatitis C, the severity of tuberculosis and other chronic illnesses

Conclusion and recommendations: High co-infection rate of hepatitis Band hepatitis C was observed in tuberculosis patients.   Decision-makers should consider incorporating screening for hepatitis Band hepatitis C viral infection during tuberculosis treatment.

Keywords: Tuberculosis, Hepatitis B, hepatitis C, drug-induced hepatitis, Ethiopia.