Mycobacterium Tuberculosis and Hepatitis Co-Infection in Dialysis Patients: Synergic Immune Dysregulation Leading to Disease Progression

Patients with end stage renal disease (ESRD) ongoing hemodialysis treatment (HD) have more than 10 [6-16] fold increased risk for development of tuberculosis (TB). The tuberculin reaction is sometimes negative; this may be due to an overwhelming infection impairing the immune response. Tuberculous cervical lymphadenitis is the commonest form of nonrespiratory TB. We report herein three dialysis patients; two of them had extrapulmonary TB, such as tuberculous lymphadenitis and had hepatitis C virus (HCV) or hepatitis B virus (HBV) infection together. Finally, it was considered that ESRD, dialysis and HCV or HBV infection might reduce the effectiveness of the body's immune system, which can allow dormant bacteria to become reactivated.