Tuberculosis

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Latent TB

Latent tuberculosis is where a patient is infected with Mycobacterium tuberculosis, but does not have active tuberculosis disease. Patients with latent tuberculosis are sometimes infectious, and it is possible to get TB from someone with latent tuberculosis. The main risk is that approximately 10% of these patients will go on to develop active tuberculosis at a later stage of their life. The identification and treatment of people with latent TB is an important part of controlling this disease.

If I have latent TB infection, how can I keep from developing active TB disease?

Many people who have latent TB infection never develop active TB disease. But some people who have latent TB infection are more likely to develop active TB disease than others. These people are at high risk for active TB disease. They include

• * people with HIV infection
• * people who became infected with TB bacteria in the last 2 years
• * babies and young children
• * people who inject illegal drugs
• * people who are sick with other diseases that weaken the immune system
• * elderly people
• * people who were not treated correctly for TB in the past

If you have latent TB infection (a positive TB skin test reaction or positive QFT-G) and you are in one of these high-risk groups, you need to take medicine to keep from developing active TB disease. This is called treatment for latent TB infection. There are several treatment options. You and your health care provider must decide which treatment is best for you.

The medicine usually taken for the treatment of latent TB infection is called isoniazid (INH). INH kills the TB bacteria that are in the body. If you take your medicine as instructed by your doctor or nurse, it can keep you from developing active TB disease. Children and people with HIV infection may need to take INH for a longer time.

Because there are less bacteria in a person with latent TB infection, treatment is much easier. Usually, only one drug is needed to treat latent TB infection. A person with active TB disease has a large amount of TB bacteria in the body. Several drugs are needed to treat active TB disease.

Sometimes people are given treatment for latent TB infection even if their skin test reaction is not positive. This is often done with infants, children, and HIV-infected people who have recently spent time with someone with active TB disease. This is because they are at very high risk of developing active TB disease soon after they become infected with TB bacteria.

It is important that you take all the pills as prescribed. If you start taking INH, you will need to see your doctor or nurse on a regular schedule. He or she will check on how you are doing. Some people have serious side effects from INH. If you have any of the following side effects, call your doctor or nurse right away:

• * no appetite
• * nausea
• * vomiting
• * yellowish skin or eyes
• * fever for 3 or more days
• * abdominal pain
• * tingling in the fingers and toes

Warning: Drinking alcoholic beverages (wine, beer, and liquor) while taking INH can be dangerous. Check with your doctor or nurse for more information.

People who have latent TB infection need to know the symptoms of active TB disease. If they develop symptoms of active TB disease, they should see a doctor right away.

Atypical TB