![]() 7 This risk is increased in children younger than four years persons with HIV infection, diabetes, and other chronic conditions those using immunosuppressant medications and those with apical fibronodular changes on chest radiography. 6 The greatest risk of progression from LTBI to active tuberculosis occurs in the first two years after infection, when about one half of the 5 to 10 percent lifetime risk occurs. 8 Groups at high risk of infection include employees of long-term care facilities, hospitals, clinics, and medical laboratories foreign-born persons from countries with a high prevalence of tuberculosis racial and ethnic minorities persons who have close contact with someone known or suspected to have active tuberculosis and residents and employees of congregate living facilities (e.g., prisons, homeless shelters). Isoniazid should be discontinued if transaminase levels are greater than three times the upper limit of normal in symptomatic patients or five times the upper limit of normal in asymptomatic patients.Īs the number of tuberculosis cases decreases, primary care physicians become less aware of high-risk patients and are less likely to consider tuberculosis in their differential diagnosis. Hepatotoxicity is the most severe adverse effect. The treatment of choice for LTBI is isoniazid for nine months. Before initiating treatment, active tuberculosis must be ruled out by patient history, physical examination, and chest radiography. All screened persons found to have LTBI should be offered treatment, regardless of age. New tests are being developed, the most promising of which are in vitro interferon-gamma release assays. ![]() Targeted tuberculin skin testing remains the most acceptable method of LTBI screening. Screening is recommended for high-risk persons, including immigrants residents and employees of congregate living facilities and persons infected with human immunodeficiency virus. Because 5 to 10 percent of persons with LTBI are at risk of progressing to active disease, identification and treatment of LTBI are essential for the elimination of tuberculosis. An estimated 10 to 15 million persons in the United States have LTBI. ![]() Latent tuberculosis infection (LTBI) is a condition in which a person is infected with Mycobacterium tuberculosis, but does not currently have active tuberculosis disease.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |