Latent Tuberculosis Infection Management Strategies

Latent tuberculosis infection (LTBI) represents a state in which individuals harbour viable Mycobacterium tuberculosis without clinical signs of active disease, posing a reservoir for future tuberculosis (TB) cases. Management strategies aim to identify persons at high risk of progression through targeted screening (tuberculin skin test or interferon-γ release assays) and to offer preventive therapy that balances efficacy, safety and completion. Short-course rifamycin-based regimens, such as once-weekly isoniazid plus rifapentine over three months, and four-month daily rifampin, have demonstrated comparable prevention of active TB with improved adherence relative to nine-month isoniazid monotherapy. Delivery models range from directly observed therapy to self-administered or hybrid approaches, often supported by patient education, adherence counselling and digital reminders. Risk stratification using clinical, epidemiological and, increasingly, host‐response biomarkers guides prioritisation in settings of limited resources. Operational research has explored integration of preventive treatment into HIV care platforms, differentiated service delivery models and community-based campaigns. These strategies collectively seek to reduce the global TB burden by interrupting transmission, optimising completion rates and tailoring interventions to diverse populations and health‐care infrastructures.

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Latent Tuberculosis Infection Management Strategies publication trend

The graph below shows the total number of articles in latent tuberculosis infection management strategies across all publications each year (not limited to Nature Index journals).

Technical terms

Latent tuberculosis infection (LTBI): A non-symptomatic infection with Mycobacterium tuberculosis in which bacteria remain dormant but may reactivate and cause active disease.

3HP regimen: A short-course LTBI therapy consisting of once-weekly doses of isoniazid plus rifapentine for three months.

Directly observed therapy (DOT): A treatment delivery approach in which a health-care worker supervises each medication dose to ensure adherence.

Cascade of care: The sequential series of steps from LTBI identification and diagnostic evaluation through initiation, adherence support and completion of preventive treatment.

References

1. Comparison of 3 optimized delivery strategies for completion of isoniazid-rifapentine (3HP) for tuberculosis prevention among people living with HIV in Uganda: A single-center randomized trial. PLOS Medicine (2024).
2. Integrating 3HP‐based tuberculosis preventive treatment into Zimbabwe's Fast Track HIV treatment model: experiences from a pilot study. Journal of the International AIDS Society (2023).
3. Guidelines for the Treatment of Latent Tuberculosis Infection: Recommendations from the National Tuberculosis Controllers Association and CDC, 2020. MMWR Recommendations and Reports (2020).
4. Interventions to reduce losses in the cascade of care for latent tuberculosis: a systematic review and meta-analysis. The International Journal of Tuberculosis and Lung Disease (2020).