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Diagnosis and Treatment of Latent Tuberculosis Infection due to Initiation of Anti-TNF Therapy

Patients with immune-mediated inflammatory diseases (IMIDs) are increasingly being treated with anti-tumor necrosis factor (TNF) agents and are at increased risk of developing tuberculosis (TB). Therefore, diagnosis and treatment of latent TB infection (LTBI) is recommended in these patients due to...

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Autor principal: Shim, Tae Sun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Tuberculosis and Respiratory Diseases 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4092157/
https://www.ncbi.nlm.nih.gov/pubmed/25024719
http://dx.doi.org/10.4046/trd.2014.76.6.261
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author Shim, Tae Sun
author_facet Shim, Tae Sun
author_sort Shim, Tae Sun
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description Patients with immune-mediated inflammatory diseases (IMIDs) are increasingly being treated with anti-tumor necrosis factor (TNF) agents and are at increased risk of developing tuberculosis (TB). Therefore, diagnosis and treatment of latent TB infection (LTBI) is recommended in these patients due to the initiation of anti-TNF therapy. Traditionally, LTBI has been diagnosed on the basis of clinical factors and a tuberculin skin test. Recently, interferon-gamma releasing assays (IGRAs) that can detect TB infection have become available. Considering the high-risk of developing TB in patients on anti-TNF therapy, the use of both a tuberculin skin test and an IGRA should be considered to detect and treat LTBI in patients with IMIDs. The traditional LTBI treatment regimen consisted of isoniazid monotherapy for 9 months. However, shorter regimens such as 4 months of rifampicin or 3 months of isoniazid/rifampicin are increasingly being used to improve treatment completion rates. In this review, the screening methods for diagnosing latent and active TB before anti-TNF therapy in patients with IMIDs will be briefly described, as well as the current LTBI treatment regimens, the recommendations for managing TB that develops during anti-TNF therapy, the necessity of regular monitoring to detect new TB infection, and the re-initiation of anti-TNF therapy in patients who develop TB.
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spelling pubmed-40921572014-07-14 Diagnosis and Treatment of Latent Tuberculosis Infection due to Initiation of Anti-TNF Therapy Shim, Tae Sun Tuberc Respir Dis (Seoul) Review Patients with immune-mediated inflammatory diseases (IMIDs) are increasingly being treated with anti-tumor necrosis factor (TNF) agents and are at increased risk of developing tuberculosis (TB). Therefore, diagnosis and treatment of latent TB infection (LTBI) is recommended in these patients due to the initiation of anti-TNF therapy. Traditionally, LTBI has been diagnosed on the basis of clinical factors and a tuberculin skin test. Recently, interferon-gamma releasing assays (IGRAs) that can detect TB infection have become available. Considering the high-risk of developing TB in patients on anti-TNF therapy, the use of both a tuberculin skin test and an IGRA should be considered to detect and treat LTBI in patients with IMIDs. The traditional LTBI treatment regimen consisted of isoniazid monotherapy for 9 months. However, shorter regimens such as 4 months of rifampicin or 3 months of isoniazid/rifampicin are increasingly being used to improve treatment completion rates. In this review, the screening methods for diagnosing latent and active TB before anti-TNF therapy in patients with IMIDs will be briefly described, as well as the current LTBI treatment regimens, the recommendations for managing TB that develops during anti-TNF therapy, the necessity of regular monitoring to detect new TB infection, and the re-initiation of anti-TNF therapy in patients who develop TB. The Korean Academy of Tuberculosis and Respiratory Diseases 2014-06 2014-06-28 /pmc/articles/PMC4092157/ /pubmed/25024719 http://dx.doi.org/10.4046/trd.2014.76.6.261 Text en Copyright©2014. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved. http://creativecommons.org/licenses/by-nc/3.0/ It is identical to the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/)
spellingShingle Review
Shim, Tae Sun
Diagnosis and Treatment of Latent Tuberculosis Infection due to Initiation of Anti-TNF Therapy
title Diagnosis and Treatment of Latent Tuberculosis Infection due to Initiation of Anti-TNF Therapy
title_full Diagnosis and Treatment of Latent Tuberculosis Infection due to Initiation of Anti-TNF Therapy
title_fullStr Diagnosis and Treatment of Latent Tuberculosis Infection due to Initiation of Anti-TNF Therapy
title_full_unstemmed Diagnosis and Treatment of Latent Tuberculosis Infection due to Initiation of Anti-TNF Therapy
title_short Diagnosis and Treatment of Latent Tuberculosis Infection due to Initiation of Anti-TNF Therapy
title_sort diagnosis and treatment of latent tuberculosis infection due to initiation of anti-tnf therapy
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4092157/
https://www.ncbi.nlm.nih.gov/pubmed/25024719
http://dx.doi.org/10.4046/trd.2014.76.6.261
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