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潜伏性结核感染的治疗:结核病控制的新机遇

Treatment of latent tuberculosis infection: renewed opportunity for tuberculosis control.

作者信息

Cohn D L

机构信息

Denver Public Health and the Division of Infectious Diseases, Department of Medicine, University of Colorado Health Sciences Center, Denver, CO, USA.

出版信息

Clin Infect Dis. 2000 Jul;31(1):120-4. doi: 10.1086/313891. Epub 2000 Jul 25.

Abstract

New recommendations for targeted tuberculin testing and treatment of latent tuberculosis (TB) infection have recently been published. Changes in nomenclature from screening to targeted tuberculin testing and from preventive therapy to treatment of latent TB infection (LTBI) are intended to promote more widespread implementation by programs and health care providers. Targeted tuberculin testing is designed to identify persons at high risk for TB and is discouraged for persons at low risk. New recommendations for treatment of LTBI in both human immunodeficiency virus (HIV)-infected and HIV-uninfected patients include isoniazid for 9 months as the preferred regimen: isoniazid for 6 months based on local program conditions, rifampin and pyrazinamide for 2 months, and rifampin for 4 months. Treatment monitoring now places greater emphasis on clinical, rather than routine, laboratory monitoring. More widespread implementation of targeted tuberculin testing and treatment of LTBI is an important control strategy that will enhance efforts to eliminate TB in the United States.

摘要

针对潜伏性结核感染的结核菌素靶向检测和治疗的新建议最近已发布。术语从筛查改为靶向结核菌素检测,以及从预防性治疗改为潜伏性结核感染(LTBI)治疗,旨在促进项目和医疗服务提供者更广泛地实施。靶向结核菌素检测旨在识别结核病高危人群,不建议对低风险人群进行检测。针对人类免疫缺陷病毒(HIV)感染和未感染患者的LTBI治疗新建议包括,异烟肼9个月疗程作为首选方案:根据当地项目情况,异烟肼6个月疗程、利福平与吡嗪酰胺2个月疗程、利福平4个月疗程。治疗监测现在更强调临床监测而非常规实验室监测。更广泛地实施靶向结核菌素检测和LTBI治疗是一项重要的控制策略,将加强美国消除结核病的努力。

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