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Diagnosis and treatment of latent tuberculosis infection.

Lee SH - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: The regimens for LTBI treatment include isoniazid, rifampicin, or isoniazid/rifampicin.However, results of drug susceptibility test from the index case must be considered in selecting the appropriate drug for recent contacts.Standardized LTBI diagnosis and treatment based on the new 2014 guidelines will contribute to the effective TB control in Korea as well as to the establishment of updated guidelines.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

ABSTRACT
A small number of viable tuberculosis bacilli can reside in an individual with latent tuberculosis infection (LTBI) without obvious clinical symptoms or abnormal chest radiographs. Diagnosis and treatment for LTBI are important for tuberculosis (TB) control in public and private health, especially in high-risk populations. The updated 2014 Korean guidelines for TB recommend that tuberculin skin tests, interferon-gamma release assays, or a combination of the two can be used for LTBI diagnosis according to age and immune status of the host as well as TB contact history. The regimens for LTBI treatment include isoniazid, rifampicin, or isoniazid/rifampicin. However, results of drug susceptibility test from the index case must be considered in selecting the appropriate drug for recent contacts. Standardized LTBI diagnosis and treatment based on the new 2014 guidelines will contribute to the effective TB control in Korea as well as to the establishment of updated guidelines.

No MeSH data available.


Related in: MedlinePlus

Latent tuberculosis infection (LTBI) diagnosis in immune-competent subjects. Appropriate method according to situations can be selected from the followings: TST alone (A), TST/IGRA two step test (B), or IGRA test alone (C)5. TB: tuberculosis; Hx: history; P.Ex: physical examination; CXR: chest radiographs.
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Figure 1: Latent tuberculosis infection (LTBI) diagnosis in immune-competent subjects. Appropriate method according to situations can be selected from the followings: TST alone (A), TST/IGRA two step test (B), or IGRA test alone (C)5. TB: tuberculosis; Hx: history; P.Ex: physical examination; CXR: chest radiographs.

Mentions: TST is the basic method to diagnose LTBI in immune-competent subjects10,12, but IGRA alone can be used13. Furthermore, a TST/IGRA two-step strategy in which the initial TST is followed by confirmatory IGRA for TST positive subjects can be used, because false positivity due to BCG vaccination or nontuberculous mycobacteria (NTM) infection can be reduced by additional IGRA test with high specificity14,15. The diagnostic approach algorithm is presented in Figure 1.


Diagnosis and treatment of latent tuberculosis infection.

Lee SH - Tuberc Respir Dis (Seoul) (2015)

Latent tuberculosis infection (LTBI) diagnosis in immune-competent subjects. Appropriate method according to situations can be selected from the followings: TST alone (A), TST/IGRA two step test (B), or IGRA test alone (C)5. TB: tuberculosis; Hx: history; P.Ex: physical examination; CXR: chest radiographs.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388901&req=5

Figure 1: Latent tuberculosis infection (LTBI) diagnosis in immune-competent subjects. Appropriate method according to situations can be selected from the followings: TST alone (A), TST/IGRA two step test (B), or IGRA test alone (C)5. TB: tuberculosis; Hx: history; P.Ex: physical examination; CXR: chest radiographs.
Mentions: TST is the basic method to diagnose LTBI in immune-competent subjects10,12, but IGRA alone can be used13. Furthermore, a TST/IGRA two-step strategy in which the initial TST is followed by confirmatory IGRA for TST positive subjects can be used, because false positivity due to BCG vaccination or nontuberculous mycobacteria (NTM) infection can be reduced by additional IGRA test with high specificity14,15. The diagnostic approach algorithm is presented in Figure 1.

Bottom Line: The regimens for LTBI treatment include isoniazid, rifampicin, or isoniazid/rifampicin.However, results of drug susceptibility test from the index case must be considered in selecting the appropriate drug for recent contacts.Standardized LTBI diagnosis and treatment based on the new 2014 guidelines will contribute to the effective TB control in Korea as well as to the establishment of updated guidelines.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

ABSTRACT
A small number of viable tuberculosis bacilli can reside in an individual with latent tuberculosis infection (LTBI) without obvious clinical symptoms or abnormal chest radiographs. Diagnosis and treatment for LTBI are important for tuberculosis (TB) control in public and private health, especially in high-risk populations. The updated 2014 Korean guidelines for TB recommend that tuberculin skin tests, interferon-gamma release assays, or a combination of the two can be used for LTBI diagnosis according to age and immune status of the host as well as TB contact history. The regimens for LTBI treatment include isoniazid, rifampicin, or isoniazid/rifampicin. However, results of drug susceptibility test from the index case must be considered in selecting the appropriate drug for recent contacts. Standardized LTBI diagnosis and treatment based on the new 2014 guidelines will contribute to the effective TB control in Korea as well as to the establishment of updated guidelines.

No MeSH data available.


Related in: MedlinePlus