Which medication can convert latent TB infection to active TB?

• A. Vaccines
• B. Antivirals
• C. Antibiotics
• D. Steroids

Answer: (D)

Immunosuppression from steroids can cause latent TB to reactivate. Latent TB means the bacteria are present but kept dormant by the immune system, especially cell-mediated immunity involving T cells and macrophages contained within granulomas. Prolonged or high-dose corticosteroids weaken this immune response, allowing the dormant bacteria to multiply and break down the granuloma, leading to active tuberculosis. This is why people on steroids are at higher risk for reactivation and why screening and treating latent TB are important before starting long courses of corticosteroids. Vaccines, antivirals, and antibiotics do not convert latent TB to active disease; vaccines aim to prevent infection or disease, antivirals target viruses, and antibiotics treat bacterial infections or treat latent TB to prevent reactivation, not promote it.