Management of latent TB infection (LTBI) involves offering drug treatments only if hepatotoxicity is not a concern, particularly in adults aged 35 to 65 years NICE CKS.
For adults, testing for HIV, hepatitis B, and C should be offered before starting treatment for LTBI NICE CKS.
The recommended treatment options include:
- 3 months of isoniazid (with pyridoxine) and rifampicin, typically given to people younger than 35 at low risk of hepatotoxicity NICE CKS.
- 6 months of isoniazid (with pyridoxine), especially when rifamycin drug interactions may be a concern (e.g., in people with HIV or transplant recipients) NICE CKS.
Patients should be linked to support services, and social needs and adherence barriers should be assessed NICE CKS.
Follow-up includes monitoring for adverse effects, particularly hepatotoxicity, and ensuring treatment completion. Patients should be advised of the risks and symptoms of TB and the importance of completing treatment NICE CKS.
In cases of treatment interruption, re-establishing treatment should be done cautiously, with investigation of causes and sequential reintroduction of drugs NICE CKS.
Post-treatment, routine follow-up is not recommended, but patients should be informed to watch for symptoms of relapse and contact the TB service promptly if symptoms develop NICE CKS.