latent tuberculosis; inactive tuberculosis
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Epidemiology
- latent tuberculosis is not transmissible[10]
Diagnostic criteria
- a positive tuberculin skin test or IFN-gamma release assay without evidence of active tuberculosis infection[3]
- persons with a history of untreated TB or radiographic evidence of previous TB
Laboratory
- tuberculin skin test or IFN-gamma release assay*
- screening for HIV1 (all patients with latent tuberculosis)
* preferred test for latent tuberculosis[3]
* see screening for tuberculosis Radiography:
- chest X-ray is normal[3]
Management
- isoniazid + rifapentine weekly for 3 months (12 weeks)[7]
- isoniazid: 15 mg/kg once weekly; max 900 mg
- rifapentine
- 10-14 kg: 300 mg weekly
- 14-25 kg: 450 mg weekly
- 25-32 kg: 600 mg weekly
- 32-50 kg: 750 mg weekly
- > 50 kg: 900 mg weekly
- isoniazid + rifampin daily for 3 months (12 weeks)[7]
- rifampin for 4 months duration (HIV negative)[3][7]
- Alternative regimens[7]
- self-administered weekly treatment for latent tuberculosis acceptable strategy in the U.S.[4]
- patients should be treated for latent tuberculosis before treatment with a biologic agent (TNF-alpha inhibitor)
- patient on TNF-alpha inhibitor found to have latent tuberculosis, should be treated*
* apparently not necessary to stop TNF-alpha inhibitor
* treat as latent tuberculosis[3]
More general terms
Additional terms
References
- ↑ Horsburgh CR and Rubin EJ. Clinical practice. Latent tuberculosis infection in the United States. N Engl J Med 2011 Apr 15; 364:1441. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21488766
- ↑ Getahun H, Matteelli A, Abubakar I et al. Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries. Eur Respir J 2015 Sep 24 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26405286
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19. American College of Physicians, Philadelphia 2015, 2018, 2021
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ 4.0 4.1 Belknap R, Holland D, Feng PJ et al Self-administered Versus Directly Observed Once-Weekly Isoniazid and Rifapentine Treatment of Latent Tuberculosis Infection: A Randomized Trial. Ann Intern Med. 2017. Nov 7. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29114781 <Internet> http://annals.org/aim/article-abstract/2661483/self-administered-versus-directly-observed-once-weekly-isoniazid-rifapentine-treatment
Getahun H, Matteelli A. Tailoring Treatment of Latent Tuberculosis to the Needs of Patients and Families. Ann Intern Med. 2017. Nov 7 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29114744 <Internet> http://annals.org/aim/article-abstract/2661484/tailoring-treatment-latent-tuberculosis-needs-patients-families
Getahun H et al. Latent Mycobacterium tuberculosis infection. N Engl J Med 2015 May 28; 372:2127 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26017823 https://www.nejm.org/doi/full/10.1056/NEJMra1405427 - ↑ Borisov AS, Bamrah Morris S, Njie GJ, et al. Update of Recommendations for Use of Once-Weekly Isoniazid- Rifapentine Regimen to Treat Latent Mycobacterium tuberculosis Infection. MMWR Morb Mortal Wkly Rep 2018;67:723-726 https://www.cdc.gov/mmwr/volumes/67/wr/mm6725a5.htm
- ↑ 6.0 6.1 Menzies D, Adjobimey M, Ruslami R et al. Four months of rifampin or nine months of isoniazid for latent tuberculosis in adults. N Engl J Med 2018 Aug 2; 379:440. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30067931PMID: 30067931 https://www.nejm.org/doi/10.1056/NEJMoa1714283
Diallo T, Adjobimey M, Ruslami R et al. Safety and side effects of rifampin versus isoniazid in children. N Engl J Med 2018 Aug 2; 379:454 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30067928 https://www.nejm.org/doi/10.1056/NEJMoa1714284 - ↑ 7.0 7.1 7.2 7.3 7.4 Sterling TR, Njie G, Zenner D, et al. Guidelines for the Treatment of Latent Tuberculosis Infection: Recommendations from the National Tuberculosis Controllers Association and CDC, 2020. MMWR Recomm Rep 2020;69(No. RR-1):1. https://www.cdc.gov/mmwr/volumes/69/rr/rr6901a1.htm
- ↑ Kim S, Thal R, Szkwarko D. Management of Latent Tuberculosis Infection. JAMA. 2023;329(5):421-422 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36656598 https://jamanetwork.com/journals/jama/fullarticle/2800774
- ↑ Shah M, Dorman SE. Latent Tuberculosis Infection. N Engl J Med. 2021 Dec 9;385(24):2271-2280. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34879450 Review. https://www.nejm.org/doi/10.1056/NEJMcp2108501
- ↑ 10.0 10.1 Minnesota Department of Health Tuberculosis (TB) Prevention and Control Program P.O. Box 64975, St. Paul, MN 55164-0975 651-201-5414 Treatment for Latent Tuberculosis (TB) Infection: Levofloxacin. https://www.health.state.mn.us/diseases/tb/basics/factsheets/levoltbi.pdf