New Treatment Regimen for Latent Tuberculosis Infection

I am Dr. Kenneth Castro, Director of the Division of
Tuberculosis Elimination at the Centers for Disease Control and Prevention. I am excited to share with
you today the release of CDC guidelines for the
use of a new regimen for the treatment of persons
with latent tuberculosis infection. Preventing TB disease by
treating those with latent TB infection is a
cornerstone of the U.S. strategy for
TB elimination. This new regimen, referred
to as the 12-dose regimen for treatment of latent
TB infection, is a combination of isoniazid
and rifapentine given once weekly in 12 doses under
directly observed therapy. This regimen is one of the
biggest breakthroughs in treatment for latent TB
infection since the 1960s, as it reduces treatment
from 270 daily doses over nine months to 12
once-weekly doses given over three months. A recent large randomized
control trial found the 12-dose regimen to be as
effective for preventing TB as other regimens. The new regimen is also more
likely to be completed than the current U.S. standard
regimen of nine months of isoniazid daily without
directly observed therapy. It’s important to realize
that the new regimen does not replace other
recommended options for treatment of persons
with latent TB infection. This regimen is
recommended as an equal alternative for otherwise
healthy persons, 12 years 12 years of age and older,
who have latent TB infection and factors that are
predictive of progressing to TB disease, such as,
recent exposure to a person with infectious
TB disease, or who have a tuberculin skin test
conversion or a positive blood test for TB. HIV-infected people who
are otherwise healthy and not taking antiretroviral
medicines are included in this category. The regimen also can be
considered for other groups when it offers
practical advantages, such as completion within
a limited timeframe. This regimen is not
recommended for children younger than 2 years of
age, HIV-infected people taking antiretroviral
therapy, pregnant women or women who expect to become
pregnant during treatment, and people who have latent
TB infection with presumed isoniazid or
rifapentine – resistance. These people should
be treated with other available regimens for
latent TB infection. The choice between the
12-dose regimen and other approved latent TB
infection treatment regimens depends on several
factors, including the feasibility of
providing directly observed therapy;
resources for drug procurement; program
operations, including patient monitoring;
expectance of treatment completion while
considering the medical and the social
circumstances of the patient; and the
preferences of the patient and the prescribing
physician. Directly observed therapy
is recommended for this 12-dose regimen. Outreach workers should
be trained on potential medication
side effects and how to educate patients about
this new regimen. Persons using the 12-dose
regimen should undergo monthly clinical
monitoring, including inquiries about side
effects and a physical assessment for signs
of adverse effects. Although blood tests
are not recommended for everyone, baseline and
subsequent tests should be done for certain groups. While the 12-dose regimen
was well tolerated in three reported treatment
trials, severe adverse effects, which is defined
as effects requiring hospital admission or
fatalities, should be reported to the Federal
Drug Administration MedWatch and local and
state health departments immediately for inclusion
in CDC’s surveillance system for adverse effects
associated with treatment for latent TB infection. More information about
latent TB infection, the available treatment
options, and educational materials for health care
professionals is available at w-w-w-dot-cdc-dot-g-o-v-forward slash-tb Thank you.

3 thoughts on “New Treatment Regimen for Latent Tuberculosis Infection

  • I have one question for who ever can answer to me. I have never had latent tuberculosis infection but on tb skin test i was positive, and i was sent to x-ray and they said i am okay but i have latent tb infection and also on the document was do not treat. so my question is can i ever be negative on tb skin test? i want to apply for some job and they do that test so i dont know if there is something or some medications i can take and became negative on tb skin test. please for answer anyone

  • If you have latent TB and it's never been reactivated why does it need to be treated with medication.  I was exposed as a baby to TB.  I am now in my late 60's.  Can I still develop full blown TB?

  • After exposure to a patient with active tb disease when will it show in the blood (how long is the incubation phase). Regarding the treatments what are the possible side effects of the drugs.

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