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TB Treatment | Print |

If I Have LTBI, How Can I Keep from Developing TB Disease?

Many people who have Latent TB Infection (LTBI) never develop TB disease. But some people who have LTBI are more likely to develop TB disease than others because they are at a higher risk for TB disease. They include:

  • People with HIV infection
  • People in close contact with a person who has infectious TB
  • People who became infected with TB bacteria in the last 2 years
  • People with weakened immune systems
  • Elderly people
  • Babies and young children
  • People who inject drugs

If you have LTBI (a positive skin test reaction or positive reaction to QuantiFeron Gold) and you are in one of these high-risk groups, you need to take medicine to treat your LTBI and keep from developing TB disease. People who have LTBI, but do not get the treatment need to recognize the symptoms of TB disease. If they develop symptoms of TB disease later on, they should see a doctor right away.

The medicine usually used for treating LTBI is a drug called Isoniazid or INH. INH kills the TB bacteria that are inactive in the body. If you take your medicine as prescribed, LTBI treatment will keep you from ever developing TB disease. Standard INH treatment lasts for 9 months.

Sometimes people are given LTBI treatment even if their TB test reaction is not positive. This is often done with infants, children, and HIV-infected people who have recently spent time with someone with infectious TB disease. This is because they are at very high risk of developing serious TB disease soon after they become infected with TB bacteria. If you are prescribed to take treatment for LTBI, it is important that you take all the pills prescribed for you so that your LTBI treatment is effective. If you start taking INH, you will need to see your doctor or nurse on a regular schedule. He or she will check on how you are doing. Very few people have serious side effects to INH. However, if you have any of the following side effects stop taking INH and call your health care provider right away:

  • No appetite
  • Nausea
  • Vomiting
  • Yellowish skin or eyes
  • Fever for more 3 days
  • Abdominal pain
  • Tingling in the fingers and toes

Warning: Drinking alcoholic beverages (wine, beer, and liquor) while taking INH can be dangerous. Check with your health care provider for more information.

What If I Have TB Disease?

If you're diagnosed with active TB, you're likely to begin taking four medications — isoniazid, rifampin, ethambutol, and pyrazinamide. TB disease can almost always be cured with medicine. But the medicine must be taken as the doctor or nurse tells you. The beginning phase of treatment is crucial for preventing the emergence of drug resistance and ensuring a good outcome. If you don’t take the pills the correct way it can be harder or not possible to cure your TB, you can stay sick for a longer time, the medicines can stop working, and you may have to take different medicines that have more side effects. Six months is the minimum acceptable duration of treatment for all adults and children with culture-positive TB.

What If I Also Have HIV Infection?

A person can have Latent TB Infection (LTBI) for years without any signs of disease. But if that person's immune system gets weak, the LTBI can quickly turn into TB disease. Also, if a person who has a weak immune system spends time with someone with active TB disease, he or she may become infected with TB bacteria and quickly develop TB disease.

Since HIV infection weakens the immune system, people with LTBI and HIV infection are at very high risk of developing TB disease. All HIV-infected people should be given a TB test to find out if they have LTBI. If they have LTBI, they need to start treatment as soon as possible to prevent them from developing TB disease. If they have TB disease, they must take medicine to cure the disease. Among people with latent TB infection, HIV infection is the strongest known risk factor for progressing to active TB disease. The chance of developing extrapulmonary tuberculosis also is increased in HIV-infected patients.

TB disease can be cured in people with HIV infection. There are a number of treatment options for HIV-infected persons with active TB disease. Without treatment, as with any other opportunistic infection, HIV and TB can work together to shorten the life of the person infected. It is critical for HIV-infected patients to be closely monitored by a physician during any type of treatment to make sure they are not hurt by side effects from taking TB and HIV medicines together. Monitoring is also vital to make sure the TB medicines are not interacting with patients’ HIV medicines in a way that could weaken the strength of the HIV medicines. The most important factor in the treatment of HIV-related tuberculosis is committing to the treatment regimen.

 

 
 

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