Pediatric Infectious Diseases: Open Access

Abstract

Latent tuberculosis infection (LTBI) is a persistent state of active immune response because of the presence of mycobacterial antigens without evidence of active tuberculosis (TB) disease). Children that are exposed to TB can get infected and develop the disease. Preventive therapy (PT) allows avoiding infection and disease. There is no gold standard to diagnose LTBI. We have two immunological based tests, in vivo and in vitro, based on the activation of T cell. Neither can differentiate between LTBI and active disease. There is no way to know if the infection has been cleared, contained or have a local infection. Risk factors for progression to disease in infected patients are HIV infection, chronic kidney disease, glucocorticoid therapy, diabetes, severe underweight and others; but an important factoris the age at which the infection takes place: children under 4 years of age are at intermediate/ high risk. At least 4 different antibiotics are needed to treat TB disease, in order to avoid risk of resistance. For LTBI we only use 1 or 2 because the risk is almost non-existent. The drug used for more than 5 decades is isoniazid (INH) and reduces TB disease incidence between 60- 90%