Tuberculosis Reactivation in a Patient with Chronic HBV Infection Undergoing PEG-Interferon Therapy: Case Report and Literature Review

Pegylated (PEG) -interferon therapy is a first-line choice to treat both chronic hepatitis B and C. Its side effects are well known and include fatigue, anaemia, weight loss, neuropsychiatric disorders, immune disregulation and white blood cells decrease. All these events could play a role in reactivation of a latent tubercular infection (LTBI), and some authors reported development of Tuberculosis (TB) during anti-HCV treatment with PEG-interferon and ribavirin. We report here the first case of TB reactivation during PEG-interferon monotherapy for HBV in a Chinese man, managed with interruption of interferon and starting of a therapy with a nucleotide analogue, in combination to anti-tubercular standard regimen, which led to a successful treatment of both diseases without significant side effects. Our report highlights the need of increasing the control of TB, by diagnosing and treating people with latent tubercular infection, that add up to one third of global population, in particular those with a high risk of reactivation.