J Korean Med Assoc.  2019 Jan;62(1):11-17. 10.5124/jkma.2019.62.1.11.

Diagnosis and treatment of latent tuberculosis infection

• Min J
• Kim JS

• KMID: 2431990
• DOI: http://doi.org/10.5124/jkma.2019.62.1.11

Abstract

In order to eliminate tuberculosis worldwide by 2050, effective management of latent tuberculosis infection is essential, and policy-makers have begun to recognize the importance of scaling up preventive therapy. The current guideline recommends targeted latent tuberculosis infection testing that identifies high-risk groups based on risk stratification for progression from latent infection to active disease. Both the tuberculin skin test and interferon-gamma releasing assay have a similar diagnostic efficacy for predicting progression to active tuberculosis. The Korean guideline recommends 9-month isoniazid monotherapy as the standard treatment; however, more evidence supports that short course rifampicin-based regimen is both more effective and tolerable than isoniazid monotherapy.

Keyword

Latent tuberculosis; Antituberculosis agent; Interferon-gamma release assay; Tuberculin skin test

MeSH Terms

Diagnosis*
Interferon-gamma
Interferon-gamma Release Tests
Isoniazid
Latent Tuberculosis*
Skin Tests
Tuberculin
Tuberculosis
Interferon-gamma
Isoniazid
Tuberculin

Reference

1. Fox GJ, Barry SE, Britton WJ, Marks GB. Contact investigation for tuberculosis: a systematic review and meta-analysis. Eur Respir J. 2013; 41:140–156.

2. Lee SH. Tuberculosis infection and latent tuberculosis. Tuberc Respir Dis (Seoul). 2016; 79:201–206.

3. Targeted tuberculin testing and treatment of latent tuberculosis infection. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. This is a Joint Statement of the American Thoracic Society (ATS) and the Centers for Disease Control and Prevention (CDC). This statement was endorsed by the Council of the Infectious Diseases Society of America. (IDSA), September 1999, and the sections of this statement. Am J Respir Crit Care Med. 2000; 161:S221–S247.

4. Uplekar M, Weil D, Lonnroth K, Jaramillo E, Lienhardt C, Dias HM, Falzon D, Floyd K, Gargioni G, Getahun H, Gilpin C, Glaziou P, Grzemska M, Mirzayev F, Nakatani H, Raviglione M. for WHO's Global TB Programme. WHO's new end TB strategy. Lancet. 2015; 385:1799–1801.

5. Cho KS. Tuberculosis control in the Republic of Korea. Tuberculosis control in the Republic of Korea. 2018; 08. 02. [Epub]. DOI: 10.4178/epih.e2018036.

6. Go UY, Park MS, Kim UN, Lee SD, Han SM, Lee JS, Yang JY, Kim JE, Park SY, Kim YM, Yoo HS, Cha JO, Park WS, Kang HY, Kim H, Park GR, Kim MJ, Park O, Son HJ, Cho EH, Na KI, Kwon YH, Lee YK, Lee KH, Jeong EK, Lee DH, Yang BG, Jeon BY, Lee JK. Korea Tuberculosis Epidemic Investigation Service. Tuberculosis prevention and care in Korea: evolution of policy and practice. J Clin Tuberc Other Mycobact Dis. 2018; 11:28–36.

7. Joint Committee for the Revision of Korean Guidelines for Tuberculosis Korea Centers for Disease Control and Prevention. Korean guidelines for tuberculosis. 3rd ed. Cheongju: Korea Centers for Disease Control and Prevention;2017.

8. Woo KS, Kim KH. Clinical applications of interferon-gamma release assays. Lab Med Online. 2016; 6:8–11.

9. Choi JC. Diagnosis and treatment of latent tuberculosis infection. J Korean Med Assoc. 2014; 57:12–18.

10. Weyer K, Gilpin C, Mirzayev F, van Gemert W. World Health Organization. Use of tuberculosis interferon-gamma release assays (IGRAs) in low- and middle-income countries. Geneva: World Health Organization;2011.

11. World Health Organization. Recommendations for investigating contacts of persons with infectious tuberculosis in low- and middle-income countries. Geneva: World Health Organization;2012.

12. World Health Organization. Guidelines on the management of latent tuberculosis infection. Geneva: World Health Organization;2015.

13. Matteelli A. World Health Organization. Recommendation on 36 months isoniazid preventive therapy to adults and adolescents living with HIV in resource-constrained and high TB- and HIV-prevalence settings: 2015 update. Geneva: World Health Organization;2015.

14. World Health Organization. Guidance for national tuberculosis programmes on the management of tuberculosis in children. 2nd ed. Geneva: World Health Organization;2014.

15. World Health Organization. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization;2018.

16. European Centre for Disease Prevention and Control. ECDC scientific advice programmatic management of latent tuberculosis infection in the European Union. Stockholm: European Centre for Disease Prevention and Control;2018.

17. Lewinsohn DM, Leonard MK, LoBue PA, Cohn DL, Daley CL, Desmond E, Keane J, Lewinsohn DA, Loeffler AM, Mazurek GH, O'Brien RJ, Pai M, Richeldi L, Salfinger M, Shinnick TM, Sterling TR, Warshauer DM, Woods GL. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis. 2017; 64:e1–e33.

18. National Institute for Health and Care Excellence. Tuberculosis [Internet]. London: National Institute for Health and Care Excellence;2016. cited 2018 Dec 19. Available from: https://www.nice.org.uk/guidance/ng33.

19. Abubakar I, Drobniewski F, Southern J, Sitch AJ, Jackson C, Lipman M, Deeks JJ, Griffiths C, Bothamley G, Lynn W, Burgess H, Mann B, Imran A, Sridhar S, Tsou CY, Nikolayevskyy V, Rees-Roberts M, Whitworth H, Kon OM, Haldar P, Kunst H, Anderson S, Hayward A, Watson JM, Milburn H, Lalvani A;. Prognostic value of interferon-γ release assays and tuberculin skin test in predicting the development of active tuberculosis (UK PREDICT TB): a prospective cohort study. Lancet Infect Dis. 2018; 18:1077–1087.

20. Zellweger JP. Predicting tuberculosis: the blood, the skin, or the Sibyl? Lancet Infect Dis. 2018; 18:1048–1049.

21. Kim HW, Kim JS. Treatment of latent tuberculosis infection and its clinical efficacy. Tuberc Respir Dis (Seoul). 2018; 81:6–12.

22. Jasmer RM, Nahid P, Hopewell PC. Clinical practice: latent tuberculosis infection. N Engl J Med. 2002; 347:1860–1866.

23. Smieja MJ, Marchetti CA, Cook DJ, Smaill FM. Isoniazid for preventing tuberculosis in non-HIV infected persons. Cochrane Database Syst Rev. 2000; (2):CD001363.

24. Zenner D, Beer N, Harris RJ, Lipman MC, Stagg HR, van der Werf MJ. Treatment of latent tuberculosis infection: an updated network meta-analysis. Ann Intern Med. 2017; 167:248–255.

25. Comstock GW. How much isoniazid is needed for prevention of tuberculosis among immunocompetent adults? Int J Tuberc Lung Dis. 1999; 3:847–850.

26. Stagg HR, Zenner D, Harris RJ, Munoz L, Lipman MC, Abubakar I. Treatment of latent tuberculosis infection: a network meta-analysis. Ann Intern Med. 2014; 161:419–428.

27. Menzies D, Adjobimey M, Ruslami R, Trajman A, Sow O, Kim H, ObengBaah J, Marks GB, Long R, Hoeppner V, Elwood K, Al-Jahdali H, Gninafon M, Apriani L, Koesoemadinata RC, Kritski A, Rolla V, Bah B, Camara A, Boakye I, Cook VJ, Goldberg H, Valiquette C, Hornby K, Dion MJ, Li PZ, Hill PC, Schwartzman K, Benedetti A. Four months of rifampin or nine months of isoniazid for latent tuberculosis in adults. N Engl J Med. 2018; 379:440–453.

28. Martinson NA, Barnes GL, Moulton LH, Msandiwa R, Hausler H, Ram M, McIntyre JA, Gray GE, Chaisson RE. New regimens to prevent tuberculosis in adults with HIV infection. N Engl J Med. 2011; 365:11–20.

29. Sterling TR, Villarino ME, Borisov AS, Shang N, Gordin F, Bliven-Sizemore E, Hackman J, Hamilton CD, Menzies D, Kerrigan A, Weis SE, Weiner M, Wing D, Conde MB, Bozeman L, Horsburgh CR Jr, Chaisson RE. TB Trials Consortium PREVENT TB Study Team. Three months of rifapentine and isoniazid for latent tuberculosis infection. N Engl J Med. 2011; 365:2155–2166.

30. Sterling TR, Scott NA, Miro JM, Calvet G, La Rosa A, Infante R, Chen MP, Benator DA, Gordin F, Benson CA, Chaisson RE, Villarino ME. Tuberculosis Trials Consortium, the AIDS Clinical Trials Group for the PREVENT TB Trial (TBTC Study 26ACTG 5259). The investigators of the TB Trials Consortium and the AIDS Clinical Trials Group for the PREVENT TB Trial are listed in the Supplement, item 17. Three months of weekly rifapentine and isoniazid for treatment of mycobacterium tuberculosis infection in HIV-coinfected persons. AIDS. 2016; 30:1607–1615.

31. Belknap R, Holland D, Feng PJ, Millet JP, Caylà JA, Martinson NA, Wright A, Chen MP, Moro RN, Scott NA, Arevalo B, Miro JM, Villarino ME, Weiner M, Borisov AS. TB Trials Consortium iAdhere Study Team. Self-administered versus directly observed once-weekly isoniazid and rifapentine treatment of latent tuberculosis infection: a randomized trial. Ann Intern Med. 2017; 167:689–697.

32. Borisov AS, Bamrah Morris S, Njie GJ, Winston CA, Burton D, Goldberg S, Yelk Woodruff R, Allen L, LoBue P, Vernon A. Update of recommendations for use of once-weekly isoniazidrifapentine regimen to treat latent mycobacterium tuberculosis infection. MMWR Morb Mortal Wkly Rep. 2018; 67:723–726.

33. Stuurman AL, VonkNoordegraaf-Schouten M, van Kessel F, Oordt-Speets AM, Sandgren A, van der Werf MJ. Interventions for improving adherence to treatment for latent tuberculosis infection: a systematic review. BMC Infect Dis. 2016; 16:257.