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In theUS, approximately 13million people have latent tuberculosis infection (LTBI),definedaspeoplewhoareinfectedwithMycobacterium
tuberculosiswho do not have symptoms and do not transmit the disease.Without treatment, approximately 5% to 10% of immunocompetent personswithLTBI develop active TB disease in their lifetimes.1
In 2016, the US Preventive Services Task Force recommended
screening all at-risk adults older than 18 years for LTBI with a blood
test (interferon-gamma release assay) or a tuberculin skin test. Atrisk individuals include those from TB-endemic regions and those
who are immunocompromised or are starting an immunosuppressive medication, such as tumor necrosis factor antagonists or systemic corticosteroids at a dose of at least 15 mg of prednisone per
day, or take immunosuppressive drugsafter organ transplant.2Evaluation for LTBI should include a medical history, physical examination, and chest radiographic imaging to rule out active TB disease.
After confirmation that active TB is not present, LTBI treatment can
be initiated. This article reviews the 2020 Centers for Disease Control and Prevention and National Tuberculosis Controllers Association LTBI treatment recommendations.1
