Latent Tuberculosis Infection

Last updated March 18, 2015
Case Authors: 
Ingrid A. Binswanger, MD, MPH
Associate Professor of Medicine
University of Colorado School of Medicine
Kaiser Permanente
Learning Objectives: 
  1. Describe the criteria used for a positive tuberculin skin test in an HIV-infected person.
  2. Discuss use of interferon gamma release assays in diagnosing latent tuberculosis. 

Display Group

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  3. Centers for Disease Control and Prevention. Trends in tuberculosis morbidity—United States, 1992-2002. MMWR Recomm Rep. 2003;52:217‐22.
  4. Alami NN, Yuen CM, Miramontes R, Pratt R, Price SF, Navin TR. Trends in tuberculosis - United States, 2013. MMWR Morb Mortal Wkly Rep. 2014;63:229-33.
  5. Centers for Disease Control and Prevention (CDC). Decrease in reported tuberculosis cases—United States, 2009. MMWR Recomm Rep. 2010;59:289-94.
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  7. Mazurek M, Jereb J, Vernon A, LoBue P, Goldberg S, Castro K; IGRA Expert Committee; Centers for Disease Control and Prevention (CDC). Updated guidelines for using Interferon Gamma Release Assays to detect Mycobacterium tuberculosis infection—United States, 2010. MMWR Recomm Rep. 2010;59(RR-5):1-25.
  8. Diagnostic Standards and Classification of Tuberculosis in Adults and Children. This official statement of the American Thoracic Society and the Centers for Disease Control and Prevention was adopted by the ATS Board of Directors, July 1999. This statement was endorsed by the Council of the Infectious Disease Society of America, September 1999. Am J Respir Crit Care Med. 2000;161:1376-95.
  9. National Tuberculosis Controllers Association; Centers for Disease Control and Prevention (CDC). Guidelines for the investigation of contacts of persons with infectious tuberculosis: recommendations from the National Tuberculosis Controllers Association and CDC. MMWR. 2005;54(No. RR-15):1-47.
  10. Centers for Disease Control and Prevention. Anergy skin testing and preventive therapy for HIV-infected persons: revised recommendations. MMWR Recomm Rep. 1997;46(No. RR-15):1-10.
  11. Gordin FM, Matts JP, Miller C, et al. A controlled trial of isoniazid in persons with anergy and human immunodeficiency virus infection who are at high risk for tuberculosis. Terry Beirn Community Programs for Clinical Research on AIDS. N Engl J Med. 1997;337:315-20.
  12. Centers for Disease Control and Prevention. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR Recomm Rep. 2000;49(RR06):1-54.
  13. Bucher HC, Griffith LE, Guyatt GH, et al. Isoniazid prophylaxis for tuberculosis in HIV infection: a meta-analysis of randomized controlled trials. AIDS. 1999;13:501-7.
  14. Menzies D. Interpretation of repeated tuberculin tests. Boosting, conversion, and reversion. Am J Respir Crit Care Med. 1999;159:15-21.
  15. Pai M, Denkinger CM, Kik SV, et al. Gamma interferon release assays for detection of Mycobacterium tuberculosis infection. Clin Microbiol Rev. 2014;27:3-20.
  16. Karam F, Mbow F, Fletcher H, et al. Sensitivity of IFN-gamma release assay to detect latent tuberculosis infection is retained in HIV-infected patients but dependent on HIV/AIDS progression. PLoS One. 2008;3:e1441.
  17. Aichelburg MC, Rieger A, Breitenecker F, et al. Detection and prediction of active tuberculosis disease by a whole-blood interferon-gamma release assay in HIV-1-infected individuals. Clin Infect Dis. 2009;48:954-62.
  18. Markowitz N, Hansen NI, Hopewell PC, et al. Incidence of tuberculosis in the United States among HIV-infected persons. The Pulmonary Complications of HIV Infection Study Group. Ann Intern Med. 1997;126:123-32.
  19. Centers for Disease Control and Prevention (CDC). Updated guidelines for the use of rifamycins for the treatment of tuberculosis among HIV-infected patients taking protease inhibitors or nonnucleoside reverse transcriptase inhibitors. MMWR. 2004;53(02):37.
  20. Centers for Disease Control and Prevention (CDC). Update: fatal and severe liver injuries associated with rifampin and pyrazinamide treatment for latent tuberculosis infection MMWR Morb Motal Wkly Rep. 2002;51:998-9.
  21. Centers for Disease Control and Prevention. Update: adverse event data and revised American Thoracic Society/CDC recommendations against the use of rifampin and pyrazinamide for treatment of latent tuberculosis infection--United States, 2003. MMWR Morb Mortal Wkly Rep. 2003;52:735-9..