Latent Tuberculosis Infection

Latent Tuberculosis Infection Persons with risk factors for Mycobacterium tuberculosis exposure or for progression to tuberculosis disease should be tested for M. tuberculosis infection, preferably with an interferon-gamma release assay. After tuberculosis disease is ruled out, those at increased risk for progression should be treated, preferably with a rifamycin-based regimen. Key Clinical Points Latent Tuberculosis Infection Prevention of progression from latent tuberculosis infection (LTBI) to tuberculosis disease is an important individual and public health goal. Adults and children should be screened for risk factors for Mycobacterium tuberculosis exposure and for risk factors for progression to tuberculosis disease. Persons who screen positive should be tested for M. tuberculosis infection, preferably with the use of an interferon-gamma release assay. Persons who test positive for M. tuberculosis infection should be assessed for tuberculosis disease. Persons with LTBI who are at increased risk for progression to tuberculosis disease generally should be treated for LTBI and followed until treatment is completed. Preferred LTBI treatment regimens include 3 months of once-weekly rifapentine plus isoniazid, 4 months of once-daily rifampin, or 3 months of once-daily isoniazid plus rifampin. Isoniazid administered once daily for 6 or 9 months is an alternative. Risk factors for hepatotoxic effects and drug-drug interactions should be considered when the LTBI treatment regimen is selected.