Reactivation of severe, acute pulmonary tuberculosis during treatment with pegylated interferon-alpha and ribavirin for chronic HCV hepatitis.
The unexpected observation of severe pulmonary tuberculosis after a 7-month combined pegylated interferon-ribavirin for chronic hepatitis C, prompted us to search an eventual immunodeficiency (lymphopenia and/or depletion of CD4+ T-lymphocytes. The retrieval of a chest radiograph incidentally performed 11 y before and showing a probable primary tuberculosis, paralleled a negligible clinical history. The enlargement of interferon indications needs careful evaluation for prior (usually missed) tuberculosis, to prevent or avoid its possible reactivation. Latent tuberculosis is increasingly reported because of extended life expectancy, immigration, and recent availability of cure for multiple chronic disorders, which are often borne by primary-secondary immunodeficiency.
Sabbatani
Sergio
S
Department of Clinical and Experimental Medicine, Division of Infectious Diseases, Bologna, Italy.
Manfredi
Roberto
R
Marinacci
Ginevra
G
Pavoni
Michele
M
Cristoni
Lorenzo
L
Chiodo
Francesco
F
D000208:Acute Disease; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D011859:Radiography; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use; D012720:Severity of Illness Index; D015898:Tomography Scanners, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology
D000998:Antiviral Agents; D016898:Interferon-alpha; D011092:Polyethylene Glycols; D012254:Ribavirin