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Semin Respir Crit Care Med 2013; 34(01): 067-086
DOI: 10.1055/s-0032-1333544
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Treatment of Latent Tuberculosis Infection

Andrew Vernon
1   Division of Tuberculosis Elimination, Clinical Research Branch, Centers for Disease Control and Prevention (CDC/OID [Office of Infectious Diseases]/NCHHSTP [National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention]), Atlanta, Georgia
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Publication History

Publication Date:
04 March 2013 (online)

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Abstract

Latent tuberculosis infection (LTBI) refers to a circumstance in which viable Mycobacterium tuberculosis (MTB) bacilli are present in an individual but symptoms and signs of active disease are lacking, and the bacilli are relatively inactive metabolically. In favorable circumstances, some of these inactive bacilli resume greater metabolic activity and replication, leading to the development of active tuberculosis disease. Treatment of this condition (TLTBI) is designed to prevent (soon, or in the distant future) this progression from asymptomatic infection to symptomatic, potentially lethal, active disease. This narrative review draws upon recent reviews of LTBI and seeks particularly to include recently published or presented data that are not included in those prior reviews. Adverse effects of treatment are considered, as are the special circumstances of human immunodeficiency virus–related LTBI, drug resistance, and use of TLTBI in the context of tumor necrosis factor alpha (TNF-α) inhibition. The review describes the main studies underpinning Centers for Disease Control and Prevention recommendations on use of the new 3-month isoniazid-rifapentine regimen and points to evolving data that may support future modification of those recommendations.

Keywords

latent TB - TB preventive therapy - TB prophylaxis - isoniazid - 3HP - rifapentine

Disclaimer

The findings and conclusions in this review are those of the author and do not necessarily represent the views of the Centers for Disease Control and Prevention.