Latent TB Infection

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Latent tuberculosis infection (LTBI) is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens without evidence of clinically manifested active TB. One third of the world’s population is estimated to be infected with M. tuberculosis. The vast majority of infected persons have no signs or symptoms of TB disease and are not infectious, but they are at risk to develop active TB disease. It is estimated that the lifetime risk of an individual with LTBI for progression to active TB is 5–10%. Among them the majority develop TB disease within the first five years after initial infection. However, the risk of developing TB disease following infection depends on several factors and the most important one is the immunological status of the host.

Prevention of active TB disease by treatment of LTBI is a critical component of the WHO End TB Strategy. Management of LTBI involves a comprehensive package of interventions that includes (1) identification and testing of pre-defined at-risk population (household and close contacts, esp. children below 5 years and ≥60 years, PLHIV and other immune-compromised patients etc.), (2) ruling out active TB disease, (3) delivering an effective and safe treatment with no or minimal loss to follow up and adverse events and (4) systematic monitoring and evaluation of the process.