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New, Simpler Way to Treat Latent TB Infection

People with latent tuberculosis (TB) infection now have another option when it comes to treatment. A new regimen for the treatment of latent TB infection, called the 12-dose regimen, reduces the number of doses and shortens the duration of treatment.

Photo: A healthcare professional in consulting a patient. More than 11 million people living in the United States have latent TB infection. People with latent TB infection have TB bacteria in their body, but do not feel sick, do not have symptoms, and cannot spread TB bacteria to others. The concern is that the latent TB infection will progress to TB disease. In fact, about 5 to 10 percent of those with latent TB infection in the United States will develop TB disease if not treated. People with latent TB infection who have weakened immune systems, including those with HIV/AIDS or diabetes, are more likely to develop TB disease after infection. For those reasons, treatment is important.

In the United States, an estimated 300,000 to 400,000 people begin treatment each year for latent TB infection, but many do not complete the lengthy treatment. The 12-dose regimen may ensure better completion rates as it simplifies and shortens treatment from 270 daily doses over nine months, to 12 once-weekly doses over three months by directly observed therapy (DOT).

This 12-dose regimen, which is detailed in new CDC guidelines, results from a large randomized control trial that found a combination of isoniazid (INH) and rifapentine (RPT) given in 12 once-weekly doses under direct observation to be as effective in preventing TB as the 270-dose INH regimen self-administered daily over nine months. Two additional studies found the 12-dose INH and RPT regimen to be as effective as other regimens in preventing new cases of TB disease.

The 12-dose regimen does not replace existing treatment options for latent TB infection. It can be considered as another option for treating latent TB infection in certain groups, including otherwise healthy people, 12 years of age and older, who were recently in contact with someone who has TB disease.

Photo: A woman taking medicine. At this time, the 12-dose regimen is not recommended in certain groups of people including young children, pregnant women or women who expect to become pregnant during treatment, and HIV-infected people taking antiretroviral therapy. These people should be treated with other existing latent TB infection treatment regimens.

While TB cases in the United States have been declining since 1993, TB remains one the world's deadliest diseases. One-third of the world's population is infected with the bacteria that cause TB, and each year, nearly 9 million people around the world become sick with TB disease.

In the United States a total of 11,182 TB cases were reported in 2010. Achieving the goal of TB elimination in the United States means not only treating those people who already have TB disease, but also successfully treating those with latent TB infection.

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