WHO consolidated guidelines on tuberculosis: tuberculosis preventive treatment: Module 1: prevention

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WHO consolidated guidelines on tuberculosis: tuberculosis preventive treatment: Module 1: prevention

Recommendations

Infants aged < 12 months living with HIV who are in contact with a person with TB and who are unlikely to have active TB on an appropriate clinical evaluation or according to national guidelines should receive TB preventive treatment.

All children living with HIV who have successfully completed treatment for TB disease may receive TB preventive treatment.

Children aged ≥ 5 years, adolescents and adults who are household contacts of people with bacteriologically confirmed pulmonary TB who are found not to have active TB by an appropriate clinical evaluation or according to national guidelines may be given TB preventive treatment

In selected high-risk household contacts of patients with multidrug-resistant tuberculosis, preventive treatment may be considered based on individualized risk assessment and a sound clinical justification.

People who are initiating anti-TNF treatment, or receiving dialysis, or preparing for an organ or haematological transplant, or who have silicosis should be systematically tested and treated for latent tuberculosis infection (LTBI).

Systematic latent tuberculosis infection (LTBI) testing and treatment may be considered for prisoners, health workers, immigrants from countries with a high TB burden, homeless people and people who use drugs.

Systematic latent tuberculosis infection (LTBI) testing and treatment is not recommended for people with diabetes, people who engage in the harmful use of alcohol, tobacco smokers and underweight people unless they also belong to other risk groups included in the above recommendations.

Chest radiography may be offered to people living with HIV on ART and preventive treatment be given to those with no abnormal radiographic findings

The absence of any symptoms of TB and the absence of abnormal chest radiographic findings may be used to rule out active TB disease among HIV-negative household contacts aged ≥ 5 years and other risk groups before preventive treatment.

Either a tuberculin skin test (TST) or interferon-gamma release assay (IGRA) can be used to test for latent tuberculosis infection (LTBI)

All household contacts of a person with HIV-associated TB should be offered HIV testing services

Partner services should be offered to people with HIV-associated TB