Treatment of Latent Tuberculosis Infection

Abstract

Latent tuberculosis infection (LTBI) is the most common source for active tuberculosis (TB), and its treatment remains an important cornerstone of global TB eradication. Although pregnancy may represent a unique time during which LTBI may be treated successfully, pregnancy and the postpartum period have been recognized as periods during which the risk of hepatitis from isoniazid (INH), the drug of choice for LTBI, may be increased. Thus, recommendations have suggested postponing treatment of LTBI until the postpartum period. Recent programs indicate that in properly designed surveillance programs, the risk of INH-induced hepatitis is low. Similar to other ongoing clinical encounters in which targeted LTBI screening and treatment may be accomplished, such as methadone and needle exchange clinics, antenatal clinics represent an opportunity to establish trust between clinician and patient for ongoing surveillance for complications and compliance. Furthermore, the addition of a newborn into the household where LTBI has been found poses new implications for eradication of TB. Prospective data collection on outcomes for such programs will be invaluable in assessing the efficacy of these efforts.