How is latent TB infection treated?

Treating latent TB infection is essential to controlling and eliminating TB in the United States, because it substantially reduces the risk that the infection will progress to TB disease.

A person with TB infection can take medication called Isoniazid or Rifampin. This will kill the TB bacteria and greatly reduce the risk of TB disease from developing. Your doctor will decide which medicine is best for you. It is important to have health monitoring every month while taking either of these medications to be sure that you are not developing any harmful side effects. Your health care provider may order blood tests during your treatment.

There is now a 12 dose regimen that makes treating latent TB infection easier.

Considered one of the biggest breakthroughs in treatment for latent TB infection (LTBI) since the 1960s, the 12-dose regimen reduces treatment from 270 daily doses over 9 months, to 12 once-weekly doses over 3 months. It is a combination regimen of isoniazid and rifapentine; two of the most effective medications available for TB treatment.

Following the results of a recent large randomized control trial, the Centers for Disease Control and Prevention (CDC) released recommendations on the use of the new treatment regimen for LTBI:

  • It is recommended for otherwise healthy people aged 12 and older who are at an increased risk of developing TB disease
  • Close patient monitoring and the utilization of Direct Observed Therapy (DOT) in which a health care worker observes a person taking the treatment and monitors side effects is required for each of the 12 doses
  • It is an additional treatment option for LTBI and is not meant to replace other available treatment regimens

More information: CDC guidelines, Recommendations for Use of an Isoniazid-Rifapentine Regimen with Direct Observation to Treat Latent Mycobacterium tuberculosis Infection (MMWR 2011; 60: 1650-1653).