+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

New approaches in the diagnosis and treatment of latent tuberculosis infection



New approaches in the diagnosis and treatment of latent tuberculosis infection



Respiratory Research 11: 169



With nearly 9 million new active disease cases and 2 million deaths occurring worldwide every year, tuberculosis continues to remain a major public health problem. Exposure to Mycobacterium tuberculosis leads to active disease in only ~10% people. An effective immune response in remaining individuals stops M. tuberculosis multiplication. However, the pathogen is completely eradicated in ~10% people while others only succeed in containment of infection as some bacilli escape killing and remain in non-replicating (dormant) state (latent tuberculosis infection) in old lesions. The dormant bacilli can resuscitate and cause active disease if a disruption of immune response occurs. Nearly one-third of world population is latently infected with M. tuberculosis and 5%-10% of infected individuals will develop active disease during their life time. However, the risk of developing active disease is greatly increased (5%-15% every year and ~50% over lifetime) by human immunodeficiency virus-coinfection. While active transmission is a significant contributor of active disease cases in high tuberculosis burden countries, most active disease cases in low tuberculosis incidence countries arise from this pool of latently infected individuals. A positive tuberculin skin test or a more recent and specific interferon-gamma release assay in a person without overt signs of active disease indicates latent tuberculosis infection. Two commercial interferon-gamma release assays, QFT-G-IT and T-SPOT.TB have been developed. The standard treatment for latent tuberculosis infection is daily therapy with isoniazid for nine months. Other options include therapy with rifampicin for 4 months or isoniazid + rifampicin for 3 months or rifampicin + pyrazinamide for 2 months or isoniazid + rifapentine for 3 months. Identification of latently infected individuals and their treatment has lowered tuberculosis incidence in rich, advanced countries. Similar approaches also hold great promise for other countries with low-intermediate rates of tuberculosis incidence.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 054600002

Download citation: RISBibTeXText

PMID: 21126375

DOI: 10.1186/1465-9921-11-169


Related references

New challenges for the pulmonologist in the diagnosis of latent tuberculosis infection: biological treatment and pulmonary tuberculosis. Archivos de Bronconeumologia 47(7): 375, 2011

Guidelines for the diagnosis and treatment of latent tuberculosis infection and active tuberculosis in patients with inflammatory joint diseases proposed for treatment with tumour necrosis factor alpha antagonist drugs. Revista Portuguesa de Pneumologia 12(5): 603-613, 2006

A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic. Canadian Respiratory Journal 2016: 7980869, 2017

Latent Tuberculosis Infection - Diagnosis and Treatment. Open Access Macedonian Journal of Medical Sciences 6(4): 651-655, 2018

Latent tuberculosis infection: diagnosis and treatment. Harefuah 141(3): 233-6, 316, 2002

Diagnosis and treatment of latent tuberculosis infection. Tuberculosis and Respiratory Diseases 78(2): 56-63, 2015

Diagnosis and treatment of latent infection with Mycobacterium tuberculosis. Respirology 18(2): 205-216, 2013

Challenges in diagnosis and treatment of latent tuberculosis infection. Indian Journal of Tuberculosis 59(1): 1-5, 2012

Diagnosis and treatment of latent tuberculosis infection: an update. Current Respiratory Care Reports 2(4): 199-207, 2014

Advances in diagnosis and treatment of latent tuberculosis infection. Journal of the American Board of Family Medicine 27(5): 704-712, 2015

Diagnosis and Treatment of Latent Tuberculosis Infection in Healthcare Workers. Tuberculosis and Respiratory Diseases 79(3): 127-133, 2016

Diagnosis and Treatment of Latent Tuberculosis Infection due to Initiation of Anti-TNF Therapy. Tuberculosis and Respiratory Diseases 76(6): 261-268, 2014

Latent M. tuberculosis infection--pathogenesis, diagnosis, treatment and prevention strategies. Polish Journal of Microbiology 61(1): 3-10, 2012

Combined use of a TST and the T-SPOT®.TB assay for latent tuberculosis infection diagnosis before anti-TNF-α treatment. International Journal of Tuberculosis and Lung Disease 16(10): 1300-1306, 2013

The frequency of tuberculosis chemoprophylaxis prior to TNF-α inhibitor treatment, and the incidence tuberculosis infection using a two-step screening algorithm for latent tuberculosis infection: data from the BioRx.si registry. Annals of the Rheumatic Diseases 71(11): 1909-1911, 2012