Dr. SERİR AKTOĞU ÖZKAN I zmir Göğüs Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi [email protected] THE TRIALS RELATED TO TREATMENT OF LTB INFECTION. THE CONTROL OF T UBERCULOSIS. to detect of patients with active tuberculosis to cure the patients with active TB
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for >40 years.
Effectiveness of the drug 25- 93 %
rate, high H resistance
2 months of R (600mg) and Z (15-20mg/kg) in
combination (RZ) proved to be as effective as 6
months of (H) treatment for prevention of TB
Disease and was well tolerated.
Halsey NA, Coberly JS, Desormeaux J et al. Randomized trials of isoniazid
Versus rifampicin and pyrazinamide for prevention of tuberculosis in HIV-1
İnfection. Lancet 1998; 351: 786-92.
2-3 months of RZ for LTBI treatment in HIV
infected patients was recommended by The
Centers for Disease Control and Prevention (CDC)
are considerd to be at high risk for developing for
active TB should be offered treatment of LTBI
ATS, CDC, AM J Respir Crit Care Med 2000;161: S221-S247
offered for treatment of LTBI and intensive
monitoring is required
MMWR 2001; 50: 733-735
JAMA; 2001: 286: 1445-1446.
6 trials: Haiti, Mexico, USA, Brazil, Spain, Zambia, Hong-Kong
2-3 months RZ versus standart 6-12 ay H regimens
Incidence of TB:
Severe advers events
2.9% 6H Gao et al. Int. J Tuberc Lung Dis 2006; 10: 1-11
July 7, 2006 / 55(RR09);1-44
Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC
Endorsed by the Advisory Council for the Elimination of Tuberculosis, the National Commission on Correctional Health Care, and the American Correctional Association
The material in this report originated in the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed), Kevin Fenton, MD, PhD, Director, and the Division of Tuberculosis Elimination, Kenneth G. Castro, MD, Director.
Corresponding address: Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed), CDC, 1600 Clifton Road, NE, MS E-10, Atlanta, GA 30333. Telephone: 404-639-8120; Fax: 404-639-8604.
No of doses
TREATMENT REGIMENS FOR LTBI
significantly more likely to complete therapy than
those receiving 9H
medical and public health recommendations.
Chest 2006; 130: 1638-1639
associated with treatment for LTBI in
people exposed to MDR-TB is far from
4-20-fold incresed risk of TB versus RA patients not
treated withTNF antagonists
Arthritis and Rheumatism 2005; 52: 1986-1992
Arthritis and Rheumatism 2003; 48: 2122-2127
should have their risk of TB assessed: history of TB
infection and treatment, a clinical examination, a
chest x-ray, Tuberculin testing
chemotherapy is required.
immunosuppressant therapy,Tuberculin testing is
affected by immunsupressant therapy.
history of TB, no immunosuppressant thrapy,
Tuberculin testing of 0-14, no further action is
needed and anti-TNF-alfa theray can be
action is needed and anti-TNF-alfa therapy can be
commencing anti TNF-alfa therapy.
should have their risk of TB assessed: history of
TB infection and treatment, chest x-ray and,
tuberculin skin testing.
(negative), no fibrocalcific lesions in chest x ray,
and no contact with TB within last year, it is
recommended to repeat tuberculin testing
If the second tuberculin testinf is 1-4 mm, there is
no need for LTBI treatment
chemoprophylaxis, therapy for LTBI may be
Following conditions are required standart
treatment with H 9 month:
tuberculin test of ≥ 5 mm
(fibrocalcific lesions and/or tuberculin
testing ≥ 5 mm and excluding active TB
within last year
immunosuppressive drug other than anti TNF-α
at the initiation of treatment.
high risk for developing to active TB
to the success of LTBI therapy