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Diagnosis and treatment of latent infection with M ycobacterium tuberculosis
Author(s) -
CHEE CYNTHIA BINENG,
SESTER MARTINA,
ZHANG WENHONG,
LANGE CHRISTOPH
Publication year - 2013
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12002
Subject(s) - medicine , tuberculosis , latent tuberculosis , tuberculin , mycobacterium tuberculosis , tuberculosis diagnosis , immunology , chemotherapy , intensive care medicine , pathology
In clinical practice, latent infection with M ycobacterium tuberculosis is defined by the presence of an M . tuberculosis ‐specific immune response in the absence of active tuberculosis. Targeted testing of individuals from risk groups with the tuberculin skin test or an interferon‐γ release assay is currently the best method to identify those with the highest risk for progression to tuberculosis. Positive predictive values of the immunodiagnostic tests are substantially influenced by the type of test, the age of the person who is tested, the prevalence of tuberculosis in the society and the risk group to which the person belongs. As a general rule, testing should only be offered when preventive chemotherapy will be accepted in the case of a positive test result. Preventive chemotherapy can effectively protect individuals at risk from the development of tuberculosis, although at least 3 months of combination therapy or up to 9 months of monotherapy are required, and overall acceptance rate is low. Improvements of the current generation of immunodiagnostic tests could substantially lower the number of individuals that need to be treated to prevent a case of tuberculosis. If shorter treatment regimens were equally effective than those currently recommended, acceptance of preventive chemotherapy could be much improved.