Abstract
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 tuberculosis (TB) disease. Individuals with LTBI represent a reservoir for active TB cases. The detection and management of LTBI is now a key component of the World Health Organization's End TB Strategy and the Government of Canada's federal framework for action on TB prevention and control. This is because people with LTBI can progress to active TB or undergo reactivation, a risk that is greatly increased in those with immunocompromising conditions. This overview provides a summary of LTBI and reactivation risk, as well as the recent advances in the diagnosis and treatment of LTBI.
Highlights
Tuberculosis (TB) is a leading cause of death worldwide, with 10.4 million cases and 1.8 million deaths in 2015 [1]
Infected individuals are classified as either having latent tuberculosis infection (LTBI), an asymptomatic clinical state that is not transmissible, or active TB disease, characterized by the presence of clinical symptoms arising from infection that can occur in multiple organs
A key part of the End TB Strategy is targeted treatment of those infected and who are at risk for progression to active TB disease
Summary
Tuberculosis (TB) is a leading cause of death worldwide, with 10.4 million cases and 1.8 million deaths in 2015 [1]. The World Health Organization’s (WHO) End TB Strategy has set the goal to reduce TB incidence globally by 90% and TB deaths by 95% by 2035 [3]. While active TB case detection has been the cornerstone of the public health response to TB, modelling suggests that in order to reach these ambitious targets, reducing the LTBI reservoir through preventative therapy is essential [3,4]. Preventing the progression of LTBI to active TB disease is an important public health goal that can substantially reduce TB transmission. A key part of the End TB Strategy is targeted treatment of those infected and who are at risk for progression to active TB disease
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