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Latent tuberculosis infection: Opportunities and challenges
Cynthia B E Chee1, Randall Reves2,3, Ying Zhang4
1TB Control Unit, Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore.
Respirology (Carlton, Vic.)
|June 15, 2018
Summary
Diagnosing and treating latent tuberculosis infection (LTBI) is crucial for global TB elimination. New diagnostics and shorter treatments show promise, but overcoming barriers to implementation remains essential.
Area of Science:
- Public Health
- Infectious Diseases
- Global Health
Background:
- Latent tuberculosis infection (LTBI) diagnosis and treatment are key WHO strategies for TB elimination.
- Barriers hinder LTBI treatment programs even in low-burden countries.
- Current diagnostics have low predictive value, and traditional isoniazid treatment has low completion rates due to duration and tolerability.
Purpose of the Study:
- To review advancements in LTBI diagnosis and treatment.
- To discuss the potential of new tools to overcome existing barriers.
- To highlight the importance of optimizing current strategies for TB elimination.
Main Methods:
- Review of emerging diagnostic tools like interferon-gamma release assays (IGRAs).
- Evaluation of newer, shorter, and better-tolerated treatment regimens using rifamycins.
- Analysis of cost-effectiveness through modeling studies.
Main Results:
- IGRAs offer more accurate LTBI diagnosis, especially in BCG-vaccinated individuals.
- Rifamycin-based treatments are safe and effective alternatives to isoniazid.
- Modeling suggests TB prevention with new tools is cost-effective.
Conclusions:
- New diagnostic and treatment tools improve TB prevention potential globally.
- Overcoming implementation barriers and optimizing current tools are vital for TB elimination.
- Further research into host-organism interactions in LTBI is needed for better future tools.
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