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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-compromised subjects. Appropriate method according to situations can be tuberculin skin test (TST)/interferon-gamma release assays (IGRA) combination test (A) or IGRA test alone (B). TST-negative result alone cannot exclude LTBI, but TST-positive result alone can indicate LTBI5. TB: tuberculosis; Hx: history; P.Ex: physical examination; CXR: chest radiographs.
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Figure 2: Latent tuberculosis infection (LTBI) diagnosis in immune-compromised subjects. Appropriate method according to situations can be tuberculin skin test (TST)/interferon-gamma release assays (IGRA) combination test (A) or IGRA test alone (B). TST-negative result alone cannot exclude LTBI, but TST-positive result alone can indicate LTBI5. TB: tuberculosis; Hx: history; P.Ex: physical examination; CXR: chest radiographs.

Mentions: IGRA alone or TST combined with IGRA can be used, but exclusion of LTBI using TST-negative result alone is not recommended. Either TST-positive or IGRA positive is regarded as LTBI in TST/IGRA combined method. The TST/IGRA two-step strategy is not recommended in immune-compromised subjects16 in contrast to immune-competent subjects17. Old spontaneously healed TB lesion without TB treatment history is regarded as LTBI, even when the LTBI test is negative. An indeterminate result on the initial IGRA test in immune-compromised subjects is frequently repeated on subsequent IGRA test18, so LTBI confirmation can be made based on TST result. The diagnostic approach algorithm is presented in Figure 2.


Diagnosis and treatment of latent tuberculosis infection.

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

Latent tuberculosis infection (LTBI) diagnosis in immune-compromised subjects. Appropriate method according to situations can be tuberculin skin test (TST)/interferon-gamma release assays (IGRA) combination test (A) or IGRA test alone (B). TST-negative result alone cannot exclude LTBI, but TST-positive result alone can indicate LTBI5. 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 2: Latent tuberculosis infection (LTBI) diagnosis in immune-compromised subjects. Appropriate method according to situations can be tuberculin skin test (TST)/interferon-gamma release assays (IGRA) combination test (A) or IGRA test alone (B). TST-negative result alone cannot exclude LTBI, but TST-positive result alone can indicate LTBI5. TB: tuberculosis; Hx: history; P.Ex: physical examination; CXR: chest radiographs.
Mentions: IGRA alone or TST combined with IGRA can be used, but exclusion of LTBI using TST-negative result alone is not recommended. Either TST-positive or IGRA positive is regarded as LTBI in TST/IGRA combined method. The TST/IGRA two-step strategy is not recommended in immune-compromised subjects16 in contrast to immune-competent subjects17. Old spontaneously healed TB lesion without TB treatment history is regarded as LTBI, even when the LTBI test is negative. An indeterminate result on the initial IGRA test in immune-compromised subjects is frequently repeated on subsequent IGRA test18, so LTBI confirmation can be made based on TST result. The diagnostic approach algorithm is presented in Figure 2.

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