Diagnosis and therapeutic approach of latent tuberculosis infection

Enferm Infecc Microbiol Clin (Engl Ed). 2018 May;36(5):302-311. doi: 10.1016/j.eimc.2017.11.014. Epub 2017 Dec 31.
[Article in English, Spanish]

Abstract

Detection and treatment of latent tuberculosis infection (LTBI) is an essential measure for tuberculosis (TB) control in low-incidence countries. However, such strategy is limited by the low predictive ability of the diagnostic tests for the development of active TB among infected people and the long-term and toxic treatment regimens. The in vitro interferon-gamma release assays are more specific and sensitive than the tuberculin skin test (TST), and enable a better selection of cases requiring treatment. Nonetheless, their capacity to predict development of TB is still poor. In addition, treatment regimens for LTBI are long, and compliance rates are low. This review discusses the use of the available diagnostic tests and the new approaches to the diagnosis of LTBI, as well as its management in different clinical scenarios.

Keywords: Diagnosis; Diagnóstico; Infección tuberculosa latente; Interferon-gamma release assays; Latent tuberculosis infection; Prueba tuberculínica; Pruebas de liberación de interferón gamma; Tratamiento; Treatment; Tuberculin skin test; Tuberculosis.

Publication types

  • Review

MeSH terms

  • Humans
  • Latent Tuberculosis / diagnosis*
  • Latent Tuberculosis / drug therapy*
  • Practice Guidelines as Topic