Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries

Haileyesus Getahun; Alberto Matteelli; Ibrahim Abubakar; Mohamed Abdel Aziz; Annabel Baddeley; Draurio Barreira; Saskia Den Boon; Susana Marta Borroto Gutierrez; Judith Bruchfeld; Erlina Burhan; Solange Cavalcante; Rolando Cedillos; Richard Chaisson; Cynthia Bin-Eng Chee; Lucy Chesire; Elizabeth Corbett; Masoud Dara; Justin Denholm; Gerard de Vries; Dennis Falzon; Nathan Ford; Margaret Gale-Rowe; Chris Gilpin; Enrico Girardi; Un-Yeong Go; Darshini Govindasamy; Alison D Grant; Malgorzata Grzemska; Ross Harris; C Robert Horsburgh; Asker Ismayilov; Ernesto Jaramillo; Sandra Kik; Katharina Kranzer; Christian Lienhardt; Philip LoBue; Knut Lönnroth; Guy Marks; Dick Menzies; Giovanni Battista Migliori; Davide Mosca; Ya Diul Mukadi; Alwyn Mwinga; Lisa Nelson; Nobuyuki Nishikiori; Anouk Oordt-Speets; Molebogeng Xheedha Rangaka; Andreas Reis; Lisa Rotz; Andreas Sandgren; Monica Sañé Schepisi; Holger J Schünemann; Surender Kumar Sharma; Giovanni Sotgiu; Helen R Stagg; Timothy R Sterling; Tamara Tayeb; Mukund Uplekar; Marieke J van der Werf; Wim Vandevelde; Femke van Kessel; Anna van't Hoog; Jay K Varma; Natalia Vezhnina; Constantia Voniatis; Marije Vonk Noordegraaf-Schouten; Diana Weil; Karin Weyer; Robert John Wilkinson; Takashi Yoshiyama; Jean Pierre Zellweger; Mario Raviglione

doi:10.1183/13993003.01245-2015

Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries

Haileyesus Getahun, Alberto Matteelli, Ibrahim Abubakar, Mohamed Abdel Aziz, Annabel Baddeley, Draurio Barreira, Saskia Den Boon, Susana Marta Borroto Gutierrez, Judith Bruchfeld, Erlina Burhan, Solange Cavalcante, Rolando Cedillos, Richard Chaisson, Cynthia Bin-Eng Chee, Lucy Chesire, Elizabeth Corbett, Masoud Dara, Justin Denholm, Gerard de Vries, Dennis FalzonNathan Ford, Margaret Gale-Rowe, Chris Gilpin, Enrico Girardi, Un-Yeong Go, Darshini Govindasamy, Alison D Grant, Malgorzata Grzemska, Ross Harris, C Robert Horsburgh, Asker Ismayilov, Ernesto Jaramillo, Sandra Kik, Katharina Kranzer, Christian Lienhardt, Philip LoBue, Knut Lönnroth, Guy Marks, Dick Menzies, Giovanni Battista Migliori, Davide Mosca, Ya Diul Mukadi, Alwyn Mwinga, Lisa Nelson, Nobuyuki Nishikiori, Anouk Oordt-Speets, Molebogeng Xheedha Rangaka, Andreas Reis, Lisa Rotz, Andreas Sandgren, Monica Sañé Schepisi, Holger J Schünemann, Surender Kumar Sharma, Giovanni Sotgiu, Helen R Stagg, Timothy R Sterling, Tamara Tayeb, Mukund Uplekar, Marieke J van der Werf, Wim Vandevelde, Femke van Kessel, Anna van't Hoog, Jay K Varma, Natalia Vezhnina, Constantia Voniatis, Marije Vonk Noordegraaf-Schouten, Diana Weil, Karin Weyer, Robert John Wilkinson, Takashi Yoshiyama, Jean Pierre Zellweger, Mario Raviglione

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3-4 month isoniazid plus rifampicin; or 3-4 month rifampicin alone.

Original language	English
Pages (from-to)	1563-1576
Number of pages	14
Journal	European Respiratory Journal
Volume	46
Issue number	6
Early online date	30 Nov 2015
DOIs	https://doi.org/10.1183/13993003.01245-2015
Publication status	Published - Dec 2015

Keywords / Materials (for Non-textual outputs)

Antirheumatic Agents/therapeutic use
Antitubercular Agents/therapeutic use
Coinfection/epidemiology
Comorbidity
Disease Management
Drug Users
Emigrants and Immigrants
Evidence-Based Medicine
HIV Infections/epidemiology
Health Personnel
Homeless Persons
Humans
Interferon-gamma Release Tests
Isoniazid/therapeutic use
Kidney Failure, Chronic/epidemiology
Latent Tuberculosis/diagnosis
Mass Screening
Practice Guidelines as Topic
Prisoners
Public Health
Radiography, Thoracic
Renal Dialysis
Rifampin/analogs & derivatives
Risk Assessment
Silicosis/epidemiology
Substance-Related Disorders/epidemiology
Transplant Recipients
Tuberculin Test
Tumor Necrosis Factor-alpha/antagonists & inhibitors
World Health Organization

Access to Document

10.1183/13993003.01245-2015

Getahun ERJ postprintAccepted author manuscript, 0.99 MB

Cite this

Getahun, H., Matteelli, A., Abubakar, I., Aziz, M. A., Baddeley, A., Barreira, D., Den Boon, S., Borroto Gutierrez, S. M., Bruchfeld, J., Burhan, E., Cavalcante, S., Cedillos, R., Chaisson, R., Chee, C. B.-E., Chesire, L., Corbett, E., Dara, M., Denholm, J., de Vries, G., ... Raviglione, M. (2015). Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries. European Respiratory Journal, 46(6), 1563-1576. https://doi.org/10.1183/13993003.01245-2015

@article{3f92d0577f2e4f4b94e1eb5cdb41ead5,

title = "Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries",

abstract = "Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3-4 month isoniazid plus rifampicin; or 3-4 month rifampicin alone.",

keywords = "Antirheumatic Agents/therapeutic use, Antitubercular Agents/therapeutic use, Coinfection/epidemiology, Comorbidity, Disease Management, Drug Users, Emigrants and Immigrants, Evidence-Based Medicine, HIV Infections/epidemiology, Health Personnel, Homeless Persons, Humans, Interferon-gamma Release Tests, Isoniazid/therapeutic use, Kidney Failure, Chronic/epidemiology, Latent Tuberculosis/diagnosis, Mass Screening, Practice Guidelines as Topic, Prisoners, Public Health, Radiography, Thoracic, Renal Dialysis, Rifampin/analogs & derivatives, Risk Assessment, Silicosis/epidemiology, Substance-Related Disorders/epidemiology, Transplant Recipients, Tuberculin Test, Tumor Necrosis Factor-alpha/antagonists & inhibitors, World Health Organization",

author = "Haileyesus Getahun and Alberto Matteelli and Ibrahim Abubakar and Aziz, {Mohamed Abdel} and Annabel Baddeley and Draurio Barreira and {Den Boon}, Saskia and {Borroto Gutierrez}, {Susana Marta} and Judith Bruchfeld and Erlina Burhan and Solange Cavalcante and Rolando Cedillos and Richard Chaisson and Chee, {Cynthia Bin-Eng} and Lucy Chesire and Elizabeth Corbett and Masoud Dara and Justin Denholm and {de Vries}, Gerard and Dennis Falzon and Nathan Ford and Margaret Gale-Rowe and Chris Gilpin and Enrico Girardi and Un-Yeong Go and Darshini Govindasamy and Grant, {Alison D} and Malgorzata Grzemska and Ross Harris and Horsburgh, {C Robert} and Asker Ismayilov and Ernesto Jaramillo and Sandra Kik and Katharina Kranzer and Christian Lienhardt and Philip LoBue and Knut L{\"o}nnroth and Guy Marks and Dick Menzies and Migliori, {Giovanni Battista} and Davide Mosca and Mukadi, {Ya Diul} and Alwyn Mwinga and Lisa Nelson and Nobuyuki Nishikiori and Anouk Oordt-Speets and Rangaka, {Molebogeng Xheedha} and Andreas Reis and Lisa Rotz and Andreas Sandgren and {Sa{\~n}{\'e} Schepisi}, Monica and Sch{\"u}nemann, {Holger J} and Sharma, {Surender Kumar} and Giovanni Sotgiu and Stagg, {Helen R} and Sterling, {Timothy R} and Tamara Tayeb and Mukund Uplekar and {van der Werf}, {Marieke J} and Wim Vandevelde and {van Kessel}, Femke and {van't Hoog}, Anna and Varma, {Jay K} and Natalia Vezhnina and Constantia Voniatis and {Vonk Noordegraaf-Schouten}, Marije and Diana Weil and Karin Weyer and Wilkinson, {Robert John} and Takashi Yoshiyama and Zellweger, {Jean Pierre} and Mario Raviglione",

note = "Copyright {\textcopyright}ERS 2015.",

year = "2015",

month = dec,

doi = "10.1183/13993003.01245-2015",

language = "English",

volume = "46",

pages = "1563--1576",

journal = "European Respiratory Journal",

issn = "0903-1936",

publisher = "European Respiratory Society",

number = "6",

}

Getahun, H, Matteelli, A, Abubakar, I, Aziz, MA, Baddeley, A, Barreira, D, Den Boon, S, Borroto Gutierrez, SM, Bruchfeld, J, Burhan, E, Cavalcante, S, Cedillos, R, Chaisson, R, Chee, CB-E, Chesire, L, Corbett, E, Dara, M, Denholm, J, de Vries, G, Falzon, D, Ford, N, Gale-Rowe, M, Gilpin, C, Girardi, E, Go, U-Y, Govindasamy, D, Grant, AD, Grzemska, M, Harris, R, Horsburgh, CR, Ismayilov, A, Jaramillo, E, Kik, S, Kranzer, K, Lienhardt, C, LoBue, P, Lönnroth, K, Marks, G, Menzies, D, Migliori, GB, Mosca, D, Mukadi, YD, Mwinga, A, Nelson, L, Nishikiori, N, Oordt-Speets, A, Rangaka, MX, Reis, A, Rotz, L, Sandgren, A, Sañé Schepisi, M, Schünemann, HJ, Sharma, SK, Sotgiu, G, Stagg, HR, Sterling, TR, Tayeb, T, Uplekar, M, van der Werf, MJ, Vandevelde, W, van Kessel, F, van't Hoog, A, Varma, JK, Vezhnina, N, Voniatis, C, Vonk Noordegraaf-Schouten, M, Weil, D, Weyer, K, Wilkinson, RJ, Yoshiyama, T, Zellweger, JP & Raviglione, M 2015, 'Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries', European Respiratory Journal, vol. 46, no. 6, pp. 1563-1576. https://doi.org/10.1183/13993003.01245-2015

TY - JOUR

T1 - Management of latent Mycobacterium tuberculosis infection

T2 - WHO guidelines for low tuberculosis burden countries

AU - Getahun, Haileyesus

AU - Matteelli, Alberto

AU - Abubakar, Ibrahim

AU - Aziz, Mohamed Abdel

AU - Baddeley, Annabel

AU - Barreira, Draurio

AU - Den Boon, Saskia

AU - Borroto Gutierrez, Susana Marta

AU - Bruchfeld, Judith

AU - Burhan, Erlina

AU - Cavalcante, Solange

AU - Cedillos, Rolando

AU - Chaisson, Richard

AU - Chee, Cynthia Bin-Eng

AU - Chesire, Lucy

AU - Corbett, Elizabeth

AU - Dara, Masoud

AU - Denholm, Justin

AU - de Vries, Gerard

AU - Falzon, Dennis

AU - Ford, Nathan

AU - Gale-Rowe, Margaret

AU - Gilpin, Chris

AU - Girardi, Enrico

AU - Go, Un-Yeong

AU - Govindasamy, Darshini

AU - Grant, Alison D

AU - Grzemska, Malgorzata

AU - Harris, Ross

AU - Horsburgh, C Robert

AU - Ismayilov, Asker

AU - Jaramillo, Ernesto

AU - Kik, Sandra

AU - Kranzer, Katharina

AU - Lienhardt, Christian

AU - LoBue, Philip

AU - Lönnroth, Knut

AU - Marks, Guy

AU - Menzies, Dick

AU - Migliori, Giovanni Battista

AU - Mosca, Davide

AU - Mukadi, Ya Diul

AU - Mwinga, Alwyn

AU - Nelson, Lisa

AU - Nishikiori, Nobuyuki

AU - Oordt-Speets, Anouk

AU - Rangaka, Molebogeng Xheedha

AU - Reis, Andreas

AU - Rotz, Lisa

AU - Sandgren, Andreas

AU - Sañé Schepisi, Monica

AU - Schünemann, Holger J

AU - Sharma, Surender Kumar

AU - Sotgiu, Giovanni

AU - Stagg, Helen R

AU - Sterling, Timothy R

AU - Tayeb, Tamara

AU - Uplekar, Mukund

AU - van der Werf, Marieke J

AU - Vandevelde, Wim

AU - van Kessel, Femke

AU - van't Hoog, Anna

AU - Varma, Jay K

AU - Vezhnina, Natalia

AU - Voniatis, Constantia

AU - Vonk Noordegraaf-Schouten, Marije

AU - Weil, Diana

AU - Weyer, Karin

AU - Wilkinson, Robert John

AU - Yoshiyama, Takashi

AU - Zellweger, Jean Pierre

AU - Raviglione, Mario

PY - 2015/12

Y1 - 2015/12

N2 - Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3-4 month isoniazid plus rifampicin; or 3-4 month rifampicin alone.

AB - Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3-4 month isoniazid plus rifampicin; or 3-4 month rifampicin alone.

KW - Antirheumatic Agents/therapeutic use

KW - Antitubercular Agents/therapeutic use

KW - Coinfection/epidemiology

KW - Comorbidity

KW - Disease Management

KW - Drug Users

KW - Emigrants and Immigrants

KW - Evidence-Based Medicine

KW - HIV Infections/epidemiology

KW - Health Personnel

KW - Homeless Persons

KW - Humans

KW - Interferon-gamma Release Tests

KW - Isoniazid/therapeutic use

KW - Kidney Failure, Chronic/epidemiology

KW - Latent Tuberculosis/diagnosis

KW - Mass Screening

KW - Practice Guidelines as Topic

KW - Prisoners

KW - Public Health

KW - Radiography, Thoracic

KW - Renal Dialysis

KW - Rifampin/analogs & derivatives

KW - Risk Assessment

KW - Silicosis/epidemiology

KW - Substance-Related Disorders/epidemiology

KW - Transplant Recipients

KW - Tuberculin Test

KW - Tumor Necrosis Factor-alpha/antagonists & inhibitors

KW - World Health Organization

U2 - 10.1183/13993003.01245-2015

DO - 10.1183/13993003.01245-2015

M3 - Article

C2 - 26405286

SN - 0903-1936

VL - 46

SP - 1563

EP - 1576

JO - European Respiratory Journal

JF - European Respiratory Journal

IS - 6

ER -

Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries

Abstract / Description of output

Keywords / Materials (for Non-textual outputs)

Access to Document

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