Screening and Management for Latent Tuberculosis Infection (LTBI) in Household Contacts

Authors

  • Jatuporn Wanchaitanawong Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University
  • Wipa Reechaipichitkul Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University
  • Apichart So-ngern Division of Sleep Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University

Keywords:

Latent tuberculosis infection; Household contacts

Abstract

Tuberculosis (TB) remains the global health problem and the most common cause of death among communicable diseases. Household contacts with active pulmonary TB patients have a chance to develop active TB disease or latent tuberculosis infection (LTBI) more than general population. Contact cases who have fever, cough, weight loss should be investigated for active TB disease by chest radiograph and sputum acid fast bacilli (AFB) staining. Contact cases who have no symptoms, normal chest radiograph and negative sputum AFB smear should be further investigated for LTBI by tuberculin skin test (TST) or interferon-gamma release assay (IGRA). Household contacts who have LTBI are at risk of progression to TB disease especially in young children and immunocompromised host. Recommended regimen for LTBI treatment included: 6 months of daily isoniazid monotherapy, 3-4 months of daily rifampicin monotherapy, 3-4 months of daily rifampicin plus isoniazid, and 3 months of weekly rifapentine plus isoniazid. The shorten regimens have noninferiority efficacy compared with 6 months of daily isoniazid monotherapy, but have much better compliance and completed treatment. Therefore, the early detection and treatment of LTBI in household contact with pulmonary TB patients is crucial to reduce the risk of developing active TB disease and impact of decreasing incidence of global TB infection.

References

1. Hartman-Adams H, Clark K, Juckett G. Update on latent tuberculosis infection. Am Fam Physician 2014; 89: 889-896.
2. World Health Organization. Global tuberculosis report 2019 (WHO/CDS/TB/2019.15). [Accessed Apr 19, 2020]. Available from: https://www.who.int/tb/publications/global_report/en/.
3. World Health Organization. Recommendations for investigating contacts of persons with infectious tuberculosis in low- and middle-income countries. World Health Organization; 2012 (WHO/HTM/TB/2012.9). [Accessed Apr 19, 2020]. Available from: https://apps.who.int/iris/handle/10665/77741.
4. Centers for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep 2005; 54 (No. RR-17): 1-141.
5. แนวทางการดำเนินงานควบคุมวัณโรคแห่งชาติ พ.ศ. 2556 (National tuberculosis control programme guidelines, Thailand, 2013). สำนักวัณโรค กรมควบคุมโรค กระทรวงสาธารณสุข. กรุงเทพ: โรงพิมพ์ชุมนุมสหกรณ์การเกษตรแห่งประเทศไทย, 2556.
6. Guwatudde D, Nakakeeto M, Jones-Lopez EC, Maganda A, Chiunda A, Mugerwa RD, et al. Tuberculosis in household contacts of infectious cases in Kampala, Uganda. Am J Epidemiol 2003; 158: 887-898.
7. Shaw JB, Wynn-Williams N. Infectivity of pulmonary tuberculosis in relation to sputum status. Am Rev Tuberc 1954; 69: 724-732.
8. Comstock GW, Ferebee SH, Hammes LM. A controlled trial of community-wide isoniazid prophylaxis in Alaska. Am Rev Respir Dis 1967; 95: 935-943.
9. Yang J, Lee S, Oh S, Han S, Park SY, Kim Y, et al. The risk of active tuberculosis among individuals living in tuberculosis-affected households in the Republic of Korea, 2015. PloS One 2019; 14: e0225744.
10. Centers for Disease Control and Prevention (CDC). Guidelines for the investigation of contacts of persons with infectious tuberculosis recommendations from the national tuberculosis controllers association and CDC. MMWR Recomm Rep 2005; 54 (RR-15): 49-55.
11. Getahun H, Matteelli A, Chaisson RE, Raviglione M. Latent Mycobacterium tuberculosis infection. N Engl J Med 2015; 372: 2127-2135.
12. Selwyn PA, Sckell BM, Alcabes P, Friedland GH, Klein RS, Schoenbaum EE. High risk of active tuberculosis in HIV-infected drug users with cutaneous anergy. JAMA 1992; 268: 504-509.
13. Markowitz N, Hansen NI, Hopewell PC, Glassroth J, Kvale PA, Mangura BT, et al. Incidence of tuberculosis in the United States among HIV-infected persons. Ann Intern Med 1997; 126: 123-132.
14. Comstock GW, Livesay VT, Woolpert SF. The prognosis of a positive tuberculin reaction in childhood and adolescence. Am J Epidemiol 1974; 99: 131-138.
15. Kiazyk S, Ball T. Latent tuberculosis infection: an overview. Can Commun Dis Rep 2017; 43: 62-66.
16. World Health Organization. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization; 2018 (WHO/CDS/TB/2018.4).
17. Lalor MK, Anderson LF, Hamblion EL, Burkitt A, Davidson JA, Maguire H, et al. Recent household transmission of tuberculosis in England, 2010–2012: retrospective national cohort study combining epidemiological and molecular strain typing data. BMC Med 2017; 15: 105.
18. Small PM, Hopewell PC. Singh SP, Paz A, Parsonnet J, Ruston DC, et al. The epidemiology of tuberculosis in San Francisco: a population-based study using conventional and molecular methods. N Engl J Med 1994; 330: 1703-1709.
19. Augustynowicz-Kopeć E, Jagielski T, Kozińska M, Kremer K, van Soolingen D, Bielecki J, et al. Transmission of tuberculosis within family-households. J Infect 2012; 64: 596-608.
20. Morrison J, Pai M, Hopewell PC. Tuberculosis and latent tuberculosis infection in close contacts of people with pulmonary tuberculosis in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2008; 8: 359-368.
21. Fox GJ, Barry SE, Britton WJ, Marks GB. Contact investigation for tuberculosis: a systematic review and meta-analysis. Eur Respir J 2012; 41: 140-156.
22. Imsanguan W, Bupachat S, Wanchaithanawong V, Luangjina S, Thawtheong S, Nedsuwan S, et al. Contact tracing for tuberculosis, Thailand. Bull World Health Organ 2020; 98: 212-218.
23. Faksri K, Reechaipichitkul W, Pimrin W, Bourpoern J, Prompinij S, et al. Transmission and risk factors for latent tuberculosis infections among index case-matched household contacts. Southeast Asian J Trop Med Public Health 2015; 46: 486-495.
24. Sharma SK, Vashishtha R, Chauhan LS, Sreenivas V, Seth D. Comparison of TST and IGRA in diagnosis of latent tuberculosis infection in a high TB-burden setting. PloS One 2017; 12: e0169539.
25. Centers for Disease Control and Prevention. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR Recomm Rep 2000; 49 (RR-6): 1-54.
26. Paton NI, Borand L, Benedicto J, Kyi MM, Mahmud AM, Norazmi MN, et al. Diagnosis and management of latent tuberculosis infection in Asia: review of current status and challenges. Int J Infect Dis 2019; 87: 21-29.
27. Diagnostic standards and classification of tuberculosis in adults and children. This official statement of the American Thoracic Society and the Centers for Disease Control and Prevention was adopted by the ATS board of directors, July 1999. This statement was endorsed by the Council of the Infectious Disease Society of America, September 1999. Am J Respir Crit Care Med 2000; 161: 1376-1395.
28. Farhat M, Greenaway C, Pai M, Menzies D. False-positive tuberculin skin tests: what is the absolute effect of BCG and non-tuberculous mycobacteria? Int Union Tuberc Lung Dis 2006; 10: 1192-1204.
29. Wang L, Turner MO, Elwood RK, Schulzer M, FitzGerald JM. A meta-analysis of the effect of Bacille Calmette Guérin vaccination on tuberculin skin test measurements. Thorax 2002; 57: 804-809.
30. Herrera V, Perry S, Parsonnet J, Banaei N. Clinical application and limitations of interferon-g release assays for the diagnosis of latent tuberculosis infection. Clin Infect Dis 2011; 52: 1031-1037.
31. Lighter J, Rigaud M, Eduardo R, Peng CH, Pollack H. Latent tuberculosis diagnosis in children by using the QuantiFERON-TB Gold In-Tube Test. Pediatrics 2009; 123: 30-37.
32. Bae W, Park KU, Song EY, Kim SJ, Lee YJ, Park JS, et al. Comparison of the sensitivity of QuantiFERON-TB Gold In-Tube and T-SPOT.TB according to patient age. PloS One 2016; 11: e0156917.
33. Reechaipichitkul W, Pimrin W, Bourpoern J, Prompinij S, Faksri K. Evaluation of the Quantiferon®-TB Gold In-tube assay and tuberculin skin test for the diagnosis of Mycobacterium tuberculosis infection in northeastern Thailand. Asian Pac J Allergy Immunol 2015; 33: 236-244.
34. Yi L, Sasaki Y, Nagai H, Ishikawa S, Takamori M, Sakashita K, et al. Evaluation of QuantiFERON-TB Gold Plus for detection of Mycobacterium tuberculosis infection in Japan. Sci Rep 2016; 6:30617.
35. Pourakbari B, Mamishi S, Benvari S, Mahmoudi S. Comparison of the QuantiFERON-TB Gold Plus and QuantiFERON-TB Gold In-Tube interferon- g release assays: a systematic review and meta-analysis. Adv Med Sci 2019; 64: 437-443.
36. Suliman S, Thompson EG, Sutherland J, Weiner 3rd J, Ota MOC, Shankar S, et al. Four-Gene Pan-African blood signature predicts progression to tuberculosis. Am J Respir Crit Care Med 2018; 197: 1198-1208.
37. Sharma S, Bose M. Role of cytokines in immune response to pulmonary tuberculosis. Asian Pac J Allergy Immunol 2001; 19: 213-219.
38. Farr K, Ravindran R, Strnad L, Chang E, Chaisson LH, Yoon C, et al. Diagnostic performance of blood inflammatory markers for tuberculosis screening in people living with HIV. PloS One 2018; 13: e0206119.
39. Kaplan G, Freedman VH. The role of cytokines in the immune response to tuberculosis. Res Immunol 1996; 147: 565-572.
40. Chang S, Wheeler LSM, Farrell KP. Public health impact of targeted tuberculosis screening in public schools. Am J Public Health 2002; 92: 1942-1945.
41. Abu-Raddad LJ, Sabatelli L, Achterberg JT, Sugimoto JD, Longini Jr IM, Dye C, et al. Epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnostics. Proc Natl Acad Sci U S A 2009; 106: 13980-13985.
42. Aggarwal AN. Quality of life with tuberculosis. J Clin Tuberc Mycobact Dis 2019; 17: 100121.
43. Chakaya J, Kirenga B, Getahun H. Long term complications after completion of pulmonary tuberculosis treatment: a quest for a public health approach. J Clin Tuberc Mycobact Dis 2016; 3: 10-12.
44. Liang HY, Li XL, Yu XS, Guan P, Yin ZH, He QC, et al. Facts and fiction of the relationship between preexisting tuberculosis and lung cancer risk: a systematic review. Int J Cancer 2009; 125: 2936-2944.
45. Smieja MJ, Marchetti CA, Cook DJ, Smaill F. Isoniazid for preventing tuberculosis in non-HIV infected persons. Cochrane Database Syst Rev 1999; CD001363.
46. International Union Against Tuberculosis Committee on Prophylaxis. Efficacy of various durations of isoniazid preventive therapy for tuberculosis: five years of follow-up in the IUAT trial. International Union Against Tuberculosis Committee on Prophylaxis. Bull World Health Organ 1982; 60: 555-564.
47. Zenner D, Beer N, Harris RJ, Lipman MC, Stagg HR, van der Werf MJ. Treatment of latent tuberculosis infection: an updated network meta-analysis. Ann Intern Med 2017; 167: 248-255.
48. Sterling TR, Njie G, Zenner D, Cohn DL, Reves R, Ahmed A, et al. Guidelines for the treatment of latent tuberculosis infection: recommendations from the National Tuberculosis Controllers Association and CDC, 2020. MMWR Recomm Rep 2020; 69 (RR-1): 1-11.
49. A double-blind placebo-controlled clinical trial of three antituberculosis chemoprophylaxis regimens in patients with silicosis in Hong Kong. Hong Kong Chest Service/Tuberculosis Research Centre, Madras/British Medical Research Council. Am Rev Respir Dis 1992; 145: 36-41.
50. Kiazyk S, Ball TB. Latent tuberculosis infection: an overview. Can Commun Dis Rep Releve Mal Transm Au Can 2017; 43: 62-66.
51. Spyridis NP, Spyridis PG, Gelesme A, Sypsa V, Valianatou M, Metsou F, et al. The effectiveness of a 9-month regimen of isoniazid alone versus 3- and 4-month regimens of isoniazid plus rifampin for treatment of latent tuberculosis infection in children: results of an 11-year randomized study. Clin Infect Dis 2007; 45: 715-722.
52. Jiménez-Fuentes MA, de Souza-Galvao ML, Mila Augé C, Solsona Peiró J, Altet-Gómez MN. Rifampicin plus isoniazid for the prevention of tuberculosis in an immigrant population. Int J Tuberc Lung Dis 2013; 17: 326-332.
53. Ena J, Valls V. Short-course therapy with rifampin plus isoniazid, compared with standard therapy with isoniazid, for latent tuberculosis infection: a meta-analysis. Clin Infect Dis 2005; 40: 670-676.
54. Menzies D, Adjobimey M, Ruslami R, Trajman A, Sow O, Kim H, et al. Four months of rifampin or nine months of isoniazid for latent tuberculosis in adults. N Engl J Med 2018; 379: 440-53.
55. Baciewicz AM, Chrisman CR, Finch CK, Self TH. Update on rifampin, rifabutin, and rifapentine drug interactions. Curr Med Res Opin 2013; 29: 1-12.
56. Sterling TR, Villarino ME, Borisov AS, Shang N, Gordin F, Bliven-Sizemore E, et al. Three months of rifapentine and isoniazid for latent tuberculosis infection. N Engl J Med 2011; 365: 2155-2166.
57. Sun HY, Huang YW, Huang WC, Chang LY, Chan PC, Chuang YC, et al. Twelve-dose weekly rifapentine plus isoniazid for latent tuberculosis infection: a multicentre randomised controlled trial in Taiwan. Tuberculosis 2018; 111: 121-126.
58. Villarino ME, Scott NA, Weis SE, Weiner M, Conde MB, Jones B, et al. Treatment for preventing tuberculosis in children and adolescents: a randomized clinical trial of a 3-month, 12-dose regimen of a combination of rifapentine and isoniazid. JAMA Pediatr 2015; 169: 247-255.
59. Wheeler C, Mohle-Boetani J. Completion rates, adverse effects, and costs of a 3-month and 9-month treatment regimen for latent tuberculosis infection in California Inmates, 2011-2014. Public Health Rep 2019; 134: 71S-79S.
60. Gordin F, Chaisson RE, Matts JP, Miller C, de Lourdes Garcia M, Hafner R, et al. Rifampin and pyrazinamide vs isoniazid for prevention of tuberculosis in HIV-infected persons: an international randomized trial. Terry Beirn Community Programs for Clinical Research on AIDS, the Adult AIDS Clinical Trials Group, the Pan American Health Organization, and the Centers for Disease Control and Prevention Study Group. JAMA 2000; 283: 1445-1450.
61. McNeill L, Allen M, Estrada C, Cook P. Pyrazinamide and rifampin vs isoniazid for the treatment of latent tuberculosis: improved completion rates but more hepatotoxicity. Chest 2003; 123: 102-106.
62. Swindells S, Ramchandani R, Gupta A, Benson CA, Leon-Cruz J, Mwelase N, et al. One month of rifapentine plus isoniazid to prevent HIV-related tuberculosis. N Engl J Med 2019; 380: 1001-1011.

Published

2020-09-08

How to Cite

1.
Wanchaitanawong J, Reechaipichitkul W, So-ngern A. Screening and Management for Latent Tuberculosis Infection (LTBI) in Household Contacts. SRIMEDJ [Internet]. 2020 Sep. 8 [cited 2024 Apr. 27];35(5):639-48. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/246710

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Review Articles