Id: 30: hepatitis b virus reactivation in an inactive carrier of chronic hbv after the initiation of treatment for tiberculosis

Discussion HBV reactivation is diagnosed by an increase HBV DNA in chronic carrier with undetectable viral load or rise HBV DNA ≥10-fold increase in HBV DNA compared with baseline. Reactivation of HBV after starting chemotherapy or immunosuppressive medications is well described. Our case report is the first to describe HBV reactivation after starting Ethambutol, levofloxacin and Capreomycin against multidrug resistant mycobacterium tuberculosis. Most studies reported that RIPE (Rifampin, Isoniazid, Pyrazinamide, and Ethambutol) tuberculosis therapy has shown no risk of HBV reactivation. One of the Multidrug resistant tuberculosis therapy agents which is levofloxacin can cause hepatoxicity but all previous studies did not report HBV reactivation. Capreomycin can cause severe hepatotoxic injury especially if combined with other potential hepatotoxic, especially medications which interferes with metabolism of P450 as reported in our case with levofloxacin. That is could be explained hepatitis B reactivation after starting capreomycin, ethambutol and levofloxacin.
Source: Journal of Investigative Medicine - Category: Research Authors: Tags: Gastroenterology/Clinical Nutrition Source Type: research