Latent Tuberculosis Infection
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Overview
Latent tuberculosis infection (LTBI) is common in refugees from high-prevalence countries. Screening and treatment can prevent progression to active TB.
Screening
Who to Screen
- All refugees from high-prevalence countries
- Not recommended for children <2 years old
Testing Options
- Tuberculin skin test (TST)
- Interferon-gamma release assay (IGRA) - Preferred in BCG-vaccinated individuals
Ruling Out Active TB
Before treating LTBI, rule out active TB with:
- Symptom screen (cough, fever, weight loss, night sweats)
- Chest X-ray
- Sputum testing if indicated
Treatment
Multiple regimens are available:
- Isoniazid (INH) 9 months
- Rifampin 4 months
- INH + Rifapentine (3HP) 12 weekly doses
Monitor liver function tests, especially in patients >35 years old or with risk factors for hepatotoxicity.
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