Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries
File(s)
Published version
Author(s)
Type
Journal Article
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.
Date Issued
2015-12-01
Date Acceptance
2015-08-26
Citation
European Respiratory Journal, 2015, 46 (6), pp.1563-1576
ISSN
1399-3003
Publisher
European Respiratory Society: ERJ
Start Page
1563
End Page
1576
Journal / Book Title
European Respiratory Journal
Volume
46
Issue
6
Copyright Statement
The content of this work is copyright of the authors or their employers. Design and branding are copyright ©ERS 2015 ERJ Open articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0
License URL
Identifier
PII: 13993003.01245-2015
Publication Status
Published
Date Publish Online
2015-11-30