Title:Diagnosis and Management of Latent Tuberculosis Infection: Updates
Volume: 24
Issue: 4
Author(s): Satish Swain, Arvind Kumar*, Vishal Kumar Vishwakarma, Adarsh Aayilliath K, Ankit Mittal and Naveet Wig
Affiliation:
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
Keywords:
World Health organisation, latent tuberculosis, tuberculosis, infection, antiretroviral therapy, Mycobacterium tuberculosis.
Abstract: India has the largest problem of tuberculosis (TB) infection globally (estimated at about
35-40 crores cases), and around 18-36 lakh develop active tuberculosis annually. Latent TB is defined
as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens with
no evidence of clinically manifested active TB. The progression of a latent infection to active tuberculosis
increases several-fold in children < 5 years of age and in people with some or the other form
of an immunocompromising condition. Therefore, to cater to this gigantic problem of tuberculosis, it
is necessary to have awareness about latent tuberculosis infection (LTBI) amongst clinicians and to
prioritise its diagnosis and treatment in high-risk groups. India plans to end TB well before the deadline
set by the World Health organisation (WHO). However, this can only be achieved with effective
strategies targeting LTBI. Multiple treatment regimens have been approved for LTBI treatment, and
all have comparable efficacy. The selection of one regimen over the other depends on various factors,
such as availability, risk of adverse events, age, and drug interactions. Recently, the WHO, as well as
the Revised National TB Control Programme (RNTCP), have updated their guidelines on TB preventive
treatment in 2020 and 2021, respectively. This review has been especially prepared to
acknowledge the differences in approach to LTBI in developed and developing countries.