Tuberc Respir Dis.  2018 Jan;81(1):6-12. 10.4046/trd.2017.0052.

Treatment of Latent Tuberculosis Infection and Its Clinical Efficacy

• Kim HW
• Kim JS

• KMID: 2420586
• DOI: http://doi.org/10.4046/trd.2017.0052

Abstract

The role of the treatment for latent tuberculosis infection (LTBI) has been underscored in the intermediate tuberculosis (TB) burden countries like South Korea. LTBI treatment is recommended only for patients at risk for progression to active TB"•those with frequent exposure to active TB cases, and those with clinical risk factors (e.g., immunocompromised patients). Recently revised National Institute for Health and Care Excellence (NICE) guideline recommended that close contacts of individuals with active pulmonary or laryngeal TB, aged between 18 and 65 years, should undergo LTBI treatment. Various regimens for LTBI treatment were recommended in NICE, World Health Organization (WHO), and Centers for Disease Control and Prevention guidelines, and superiority of one recommended regimen over another was not yet established. Traditional 6 to 9 months of isoniazid (6H or 9H) regimen has an advantage of the most abundant evidence for clinical efficacy"•60%-90% of estimated protective effect. However, 6H or 9H regimen is related with hepatotoxicity and low compliance. Four months of rifampin regimen is characterized by less hepatotoxicity and better compliance than 9H, but has few evidence of clinical efficacy. Three months of isoniazid plus rifampin was proved equivalence with 6H or 9H regimen in terms of efficacy and safety, which was recommended in NICE and WHO guidelines. The clinical efficacy of isoniazid plus rifapentine once-weekly regimen for 3 months was demonstrated recently, which is not yet introduced into South Korea.

Keyword

Latent Tuberculosis; Antitubercular Agents; Treatment Outcome; Interferon-Gamma Release Tests; Tuberculin Test; Epidemiology

MeSH Terms

Antitubercular Agents
Centers for Disease Control and Prevention (U.S.)
Compliance
Epidemiology
Humans
Interferon-gamma Release Tests
Isoniazid
Korea
Latent Tuberculosis*
Rifampin
Risk Factors
Treatment Outcome*
Tuberculin Test
Tuberculosis
World Health Organization
Antitubercular Agents
Isoniazid
Rifampin

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