3/5/2023 0 Comments Dr coblyn infectious disease![]() Positive Results for TST or IGRA TestsĬhest radiographs are abnormal in most cases of TB disease, however in patients with immunosuppression or extra-pulmonary disease the chest radiograph is normal. Proper treatment of LTBI can prevent TB diseaseįever, cough, chest pain, weight loss, night sweats, hemoptysis, fatigue, and decreased appetite are common symptoms of TB disease.Ĥ.2.1. Usually positive results for TST or IGRA tests Latent Tuberculosis Infectionįinding no symptoms and physical evidence of TB Latent Tuberculosis Infection and Disease Differentiation 4.1. Before treatment of LTBI, the existence of TB disease must be excluded since inadequate treatment and development of drug resistance can lead to failure of treatment ( 6).Ĥ. ![]() Medical Records, TST or interferon gamma release assay (IGRA) results, chest radiograph, physical examination and sputum examinations in certain circumstances can be used for detection of LTBI. ![]() Detection of Latent Tuberculosis Infection Note, the risk of progression is greatest in the first 1 or 2 years after infection ( 6).ģ. Silicosis, diabetes mellitus, chronic renal failure or on hemodialysis, gastrectomy, jejunoileal bypass, solid organ transplant, head and neck cancerĦ) Recent tuberculin skin test (TST) converters (that is, people with baseline testing results who have an increase of 10 mm or more in the size of the TST reaction within a two-year period)ħ) Infants and children under the age of five who have a positive TB test result ( 6). Overall, TB afflicted patients belong to two major groups:Ī) People who are at risk of exposure to TB patients including:ġ) Close contact with TB afflicted patientsģ) People who are working in institutions or hospitals that care for TB, nursing homes, or residential facilities for patients with HIV infection/AIDSī) People with specific conditions who are at risk of progression from LTBI to TB disease:ģ) Those with radiographic evidence of prior healed TBĤ) Those with low body weight (10% below ideal)ĥ) Patients with other medical conditions such as: In this way unfocused population-based testing is avoided as it is neither cost-effective nor useful and leads to unnecessary treatment ( 5). tuberculosis is detected, control and evaluation of LTBI in high-risk groups for developing TB disease becomes highly important, hence targeted testing is essential and can prevent the spread of TB and control disease progression. In the present paper, we reviewed the latest guidelines and articles by using a comprehensive search of reliable data-bases such as PubMed and ISI on diagnosis and treatment of latent tuberculosis.Īmong high-risk groups, TB testing must be performed in order to treat LTBI. Owing to the fact that diagnosis of LTBI has a major role in controlling of tuberculosis, it is highly vital to find the best diagnostic strategies for LTBI. An important strategy for TB control is utilization of rapid, accurate, and inexpensive ways for detection of active TB. To achieve the United Nations Millennium Goals of eliminating the disease by 2050, diagnosis and treatment of this active disease with new approaches to reduce this vast reservoir of latent tuberculosis infection (LTBI) is vital ( 4). Nowadays incidence and mortality from TB is at a steady rate, which is the result of governmental and non-governmental organization efforts and investments in the last decades in order to control this infection ( 3). People who are living with HIV are more exposed to death because of TB and combination of TB and HIV ( 2). According to statistics, 530000 children became ill with TB and 74000 HIV-negative children died from TB in 2012. Most deaths related to TB (95%) occur in poor and middle-income countries also TB is one of the three causes of death among women aged 15 to 44 years of age. According to released data 8.6 million people are infected by TB and 1.3 million die from TB. After HIV/AIDS, TB causes the greatest number of deaths due to a single infectious agent. Tuberculosis (TB) is a serious cause of morbidity and mortality all over the world ( 1). Latent Tuberculosis BCG Interferon-gamma Release Tests 1. Here we review the clinical applications, advantages, and limitations of the tuberculin skin test and interferon-gamma release assays and provide an overview of the most recent systematic reviews conducted for the comparison of these tests.
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