[Reactivation of tuberculosis during treatment with inhibitors of TNF]

Reactivation of tuberculosis during treatment with inhibitors of TNF. The inhibition of the tumor necrosis factor (TNF) has been a major progress in the treatment of chronic inflammatory diseases by acting on their local and systemic manifestations. However, this treatment can be responsible for severe infections, specifically reactivation of tuberculosis. The underlying mechanisms of these infections in this context are now better understood. First, chronic inflammatory diseases are associated with a cellular mediated immune defect, specifically affecting the Th1 pathway. On the other hand, TNF has a central role in granuloma formation. TNF inhibition allows the escape of tuberculosis bacillus from residual sites and its rapid diffusion. This understanding has allowed the implementation of prevention measures with screening and treatment of latent tuberculosis.