Preventive therapy for latent tuberculosis infection—the promise and the challenges
Around one third of the world's population may harbour latent tuberculosis infection (LTBI), an asymptomatic immunological state that confers a heightened risk of subsequently developing tuberculosis (TB). Effectively treating LTBI will be essential if the End TB Strategy is to be realized. Thi...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-03-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971216312231 |
| _version_ | 1818926216485273600 |
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| author | G.J. Fox C.C. Dobler B.J. Marais J.T. Denholm |
| author_facet | G.J. Fox C.C. Dobler B.J. Marais J.T. Denholm |
| author_sort | G.J. Fox |
| collection | DOAJ |
| description | Around one third of the world's population may harbour latent tuberculosis infection (LTBI), an asymptomatic immunological state that confers a heightened risk of subsequently developing tuberculosis (TB). Effectively treating LTBI will be essential if the End TB Strategy is to be realized. This review evaluates the evidence in relation to the effectiveness of preventive antibiotic therapy to treat LTBI due to both drug-susceptible and drug-resistant bacteria. Current national and international preventive therapy guidelines are summarized, as well as ongoing randomized trials evaluating regimens to prevent drug-resistant TB. Populations that may benefit most from screening and treatment for LTBI include close contacts of patients with TB (particularly children under 5 years of age) and individuals with substantial immunological impairment. The risks and benefits of treatment must be carefully balanced for each individual. Electronic decision support tools offer one way in which clinicians can help patients to make informed decisions. Modelling studies indicate that the expanded use of preventive therapy will be essential to achieving substantial reductions in the global TB burden. However, the widespread scale-up of screening and treatment will require careful consideration of cost-effectiveness, while ensuring the drivers of ongoing disease transmission are also addressed. |
| first_indexed | 2024-12-20T02:53:36Z |
| format | Article |
| id | doaj.art-1fb7ef328a57490a8cb8ad1ad67ffed0 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 1878-3511 |
| language | English |
| last_indexed | 2024-12-20T02:53:36Z |
| publishDate | 2017-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-1fb7ef328a57490a8cb8ad1ad67ffed02022-12-21T19:55:58ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112017-03-0156C687610.1016/j.ijid.2016.11.006Preventive therapy for latent tuberculosis infection—the promise and the challengesG.J. Fox0C.C. Dobler1B.J. Marais2J.T. Denholm3Sydney Medical School, Room 574 Blackburn Building, University of Sydney, Sydney, 2006, AustraliaSydney Medical School, Room 574 Blackburn Building, University of Sydney, Sydney, 2006, AustraliaThe Children's Hospital at Westmead and the Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, AustraliaVictorian Tuberculosis Program, Melbourne Health, Victoria, AustraliaAround one third of the world's population may harbour latent tuberculosis infection (LTBI), an asymptomatic immunological state that confers a heightened risk of subsequently developing tuberculosis (TB). Effectively treating LTBI will be essential if the End TB Strategy is to be realized. This review evaluates the evidence in relation to the effectiveness of preventive antibiotic therapy to treat LTBI due to both drug-susceptible and drug-resistant bacteria. Current national and international preventive therapy guidelines are summarized, as well as ongoing randomized trials evaluating regimens to prevent drug-resistant TB. Populations that may benefit most from screening and treatment for LTBI include close contacts of patients with TB (particularly children under 5 years of age) and individuals with substantial immunological impairment. The risks and benefits of treatment must be carefully balanced for each individual. Electronic decision support tools offer one way in which clinicians can help patients to make informed decisions. Modelling studies indicate that the expanded use of preventive therapy will be essential to achieving substantial reductions in the global TB burden. However, the widespread scale-up of screening and treatment will require careful consideration of cost-effectiveness, while ensuring the drivers of ongoing disease transmission are also addressed.http://www.sciencedirect.com/science/article/pii/S1201971216312231TuberculosisLatent tuberculosisMycobacterium tuberculosisDrug therapyRisk factorsMass screening |
| spellingShingle | G.J. Fox C.C. Dobler B.J. Marais J.T. Denholm Preventive therapy for latent tuberculosis infection—the promise and the challenges International Journal of Infectious Diseases Tuberculosis Latent tuberculosis Mycobacterium tuberculosis Drug therapy Risk factors Mass screening |
| title | Preventive therapy for latent tuberculosis infection—the promise and the challenges |
| title_full | Preventive therapy for latent tuberculosis infection—the promise and the challenges |
| title_fullStr | Preventive therapy for latent tuberculosis infection—the promise and the challenges |
| title_full_unstemmed | Preventive therapy for latent tuberculosis infection—the promise and the challenges |
| title_short | Preventive therapy for latent tuberculosis infection—the promise and the challenges |
| title_sort | preventive therapy for latent tuberculosis infection the promise and the challenges |
| topic | Tuberculosis Latent tuberculosis Mycobacterium tuberculosis Drug therapy Risk factors Mass screening |
| url | http://www.sciencedirect.com/science/article/pii/S1201971216312231 |
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