Question

A 42-year-old man from a high tuberculosis-prevalence country has a positive interferon-gamma release assay on screening before starting TNF-alpha inhibitor therapy. Chest X-ray is normal and he is asymptomatic. What is the most appropriate next step?

Accepted Answer

Latent TB treatment with isoniazid or rifampicin-based regimen

Answer

No treatment, as he has no symptoms

Answer

Full 6-month RIPE regimen as for active TB

Answer

Repeat IGRA in 12 months

Answer

Start TNF-alpha inhibitor without TB therapy

Practice question

A 42-year-old man from a high tuberculosis-prevalence country has a positive interferon-gamma release assay on screening before starting TNF-alpha inhibitor therapy. Chest X-ray is normal and he is asymptomatic. What is the most appropriate next step?