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Needed: New and Better Tools to Combat Latent Tuberculosis Infection

Henry M. Blumberg, MD
[+] Article, Author, and Disclosure Information

From Emory University School of Medicine, Atlanta, GA 30303.

Grant Support: By the National Institutes of Health/Fogarty International Center (D43TW007124) and National Institutes of Health/National Center for Research Resources (UL1RR025008).

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Henry M. Blumberg, MD, Division of Infectious Diseases, Emory University School of Medicine, 49 Jesse Hill Jr. Drive, Atlanta, GA 30303; e-mail, henry.m.blumberg@emory.edu.

Ann Intern Med. 2008;149(10):761-763. doi:10.7326/0003-4819-149-10-200811180-00011
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Treatment of latent tuberculosis infection (LTBI) is a major strategy for tuberculosis control in the United States, Canada, and selected resource-intensive countries (12). Given the decline in tuberculosis cases in the United States since 1992, interest in treating patients with LTBI is renewed in order to eliminate the large reservoir of individuals at risk for progression to tuberculosis (1, 3). The Centers for Disease Control and Prevention, such professional organizations as the American Thoracic Society and the Infectious Diseases Society of America, and others (13) recommend targeted testing of persons at increased risk for tuberculosis and provision of therapy for LTBI after active tuberculosis disease has been excluded. Persons at greatest risk for progression to active tuberculosis disease after infection with Mycobacterium tuberculosis include those with HIV infection (the greatest single risk factor for progression) or recent tuberculosis infection, immigrants with LTBI from high endemic areas (especially within their first year in the United States), and those with LTBI and selected underlying illnesses (for example, silicosis, diabetes mellitus, chronic renal failure, some malignant conditions, and immunosuppressive medications) (1, 3).

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