A small number of viable
tuberculosis bacilli can reside in an individual with
latent tuberculosis infection (LTBI) without obvious clinical symptoms or abnormal
chest radiographs.
Diagnosis and
treatment of LTBI are important for
tuberculosis (TB) control in public and private
healthcare facilities, particularly in high-
risk populations. The updated 2017 Korean guidelines for TB recommend that
tuberculin skin tests,
interferon-gamma release assays, or a combination of them can be used for the
diagnosis of LTBI, depending on the age and immune status of the
patient as well as their TB contact
history. For
diagnosis of LTBI, exclusion of active TB is essential, and the possibility of healed TB in those without a
history of
treatment for TB but at
risk of its development must be considered. The
treatment options for LTBI include
isoniazid,
rifampicin,
isoniazid/
rifampicin, and
isoniazid/rifapentine. The
benefits and risks of these agents based on the age of the
patient and their hepatotoxicity must be considered when selecting the appropriate
drug. Standardized
diagnosis and
treatment of LTBI based on the updated 2017 guidelines
will contribute to the control of TB in
Korea as well as to further revisions of the guidelines.