Author:
Getahun Haileyesus,Matteelli Alberto,Abubakar Ibrahim,Aziz Mohamed Abdel,Baddeley Annabel,Barreira Draurio,Den Boon Saskia,Borroto Gutierrez Susana Marta,Bruchfeld Judith,Burhan Erlina,Cavalcante Solange,Cedillos Rolando,Chaisson Richard,Chee Cynthia Bin-Eng,Chesire Lucy,Corbett Elizabeth,Dara Masoud,Denholm Justin,de Vries Gerard,Falzon Dennis,Ford Nathan,Gale-Rowe Margaret,Gilpin Chris,Girardi Enrico,Go Un-Yeong,Govindasamy Darshini,D. Grant Alison,Grzemska Malgorzata,Harris Ross,Horsburgh Jr C. Robert,Ismayilov Asker,Jaramillo Ernesto,Kik Sandra,Kranzer Katharina,Lienhardt Christian,LoBue Philip,Lönnroth Knut,Marks Guy,Menzies Dick,Migliori Giovanni Battista,Mosca Davide,Mukadi Ya Diul,Mwinga Alwyn,Nelson Lisa,Nishikiori Nobuyuki,Oordt-Speets Anouk,Rangaka Molebogeng Xheedha,Reis Andreas,Rotz Lisa,Sandgren Andreas,Sañé Schepisi Monica,Schünemann Holger J.,Sharma Surender Kumar,Sotgiu Giovanni,Stagg Helen R.,Sterling Timothy R.,Tayeb Tamara,Uplekar Mukund,van der Werf Marieke J.,Vandevelde Wim,van Kessel Femke,van't Hoog Anna,Varma Jay K.,Vezhnina Natalia,Voniatis Constantia,Vonk Noordegraaf-Schouten Marije,Weil Diana,Weyer Karin,Wilkinson Robert John,Yoshiyama Takashi,Zellweger Jean Pierre,Raviglione Mario
Abstract
Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3–4 month isoniazid plus rifampicin; or 3–4 month rifampicin alone.
Publisher
European Respiratory Society (ERS)
Subject
Pulmonary and Respiratory Medicine