Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Indian J Pediatr. 2024 Aug;91(8):823-829. doi: 10.1007/s12098-023-04969-z. Epub 2023 Dec 14.
Some individuals exposed to Mycobacterium tuberculosis develop a latent infection and remain at a lifelong risk of developing tuberculosis (TB) disease, a state called as TB infection (TBI). TB preventive treatment (TPT) aims to treat TBI and prevent progression to active TB in an exposed or infected person. Currently, it is not possible to confirm TBI microbiologically, but can be identified indirectly by means of immune-based tests [Tuberculin skin test (TST), interferon-gamma release assays (IGRAs)]. It is crucial to rule out active TB before initiating TPT. TPT regimens have evolved with time. The most widely used regimen is 6 mo of daily Isoniazid (INH) (6H). Another regime in pipeline for persons >2 y, but not yet widely available, is 3HP (3 mo of weekly Isoniazid and Rifapentine). TPT to contacts of drug resistant TB (DR-TB) patients needs to be tailored depending on the resistance pattern in the index case, and relies on a bacteriological confirmation of the same. Individuals receiving TPT should be closely monitored for emergence of any signs or symptoms suggestive of active TB disease while on TPT.
一些接触结核分枝杆菌的个体发展为潜伏感染,并终生存在发展为结核病(TB)疾病的风险,这种状态称为结核感染(TBI)。结核预防治疗(TPT)旨在治疗 TBI 并预防暴露或感染的个体发展为活动性 TB。目前,无法通过微生物学方法确认 TBI,但可以通过免疫为基础的检测(结核菌素皮肤试验(TST)、干扰素-γ释放试验(IGRAs))间接识别。在开始 TPT 之前,必须排除活动性 TB。TPT 方案随着时间的推移而发展。最广泛使用的方案是 6 个月每日异烟肼(INH)(6H)。另一种方案适用于年龄>2 岁的人群,但尚未广泛应用,即 3HP(3 个月每周异烟肼和利福平)。对耐多药结核病(DR-TB)患者接触者的 TPT 需要根据索引病例的耐药模式进行调整,并依赖于对相同病例的细菌学确认。接受 TPT 的个体在接受 TPT 期间应密切监测任何提示活动性 TB 疾病的迹象或症状。