This ppt is about latent tuberculosis and active tuberculosis (IN SHORT) hope it will be helpful by shaila robert hameldon

1. LATENT AND
ACTIVE
TUBERCULOSIS
D O N E B Y - G R O U P 5 A
T B I L I S I S T A T E M E D I C A L U N I V E R S I T Y
S H A I L A R O B E R T H A M E L D O N

2. OUTLINE
• What is tuberculosis ?
• TB infection VS TB diseases
• Active and latent TB
• Diagnosis
• Treatment
• Latent TB VS active TB

3. Tuberculosis is a disease caused by
Mycobacterium tuberculosis; which
typically affects the lungs. It is a
common infectious cause of morbidity
and mortality worldwide. Primary
infection, transmitted via airborne
aerosol droplet nuclei, is often initially
asymptomatic. M. Tuberculosis infection
is typically dormant (latent B infection)
because of intact innate and cellular
immune response. If the immune
system is compromised, however,
reactivation of the infection may occur
and can lead to active TB.

4. ØThere is a difference between TB INFECTION and TB DISEASE
§ It is possible to be infected with TB and not develop TB disease
§ About 10% of people living with TB infection develop TB disease
§ People can progress directly to developing active disease without having a
long "latent" period.
Ø [Latent] TB infection (LTBi)refers to the period when the immune system is
successful in containing the TB and preventing progression to disease
§ The TB bacilli remains encased in a hard shell called a tubercle .
Ø [Active ] Active TB disease refers to the time when TB is no longer contained
by the immune system and causes disease
Ø These were previously thought to be two different disease states now they are
thought to be part of a disease spectrum in which latent TB could be early-
stage (sub clinical) active TB with a smaller number of bacteria
TB INFECTION VS TB DISEASE

5. TB INFECTION PROGRESS TO ACTIVE TB
TB infection can progress to active disease when the body becomes weak, for example from
malnutrition, immune suppression, or advanced age
Among people living with HIV and without reliable access to effective HIV treatment the immune
system becomes compromised and more vulnerable to the progression of TB infection into
TB
• TB is a common co-infection among, and the
• leading killer of, people living with HIV
• People living with HIV are up to 21X more likely to develop TB disease than people without LIV
Young children are up to 10X more likely to develop TB and tend to develop more severe forms of
TB

6. L ATENT
TB

8. ACTIVE
TB

9. A C T I V E T B S Y M P T O M S

10. DIAGNOSIS
Interpretation of results
• IGRA
– Positive: TB infection is likely
– Negative: TB infection is unlikely, but
cannot be excluded
– Indeterminate: can occur
in immunosuppressed states, and a
repeat IGRA or TST can be useful [65]
TST: Depending on patient characteristics,
a TST can be positive with an induration > 5
mm, > 10 mm, or > 15 mm.
For healthy individuals with no risk factors, an
induration < 15 mm is considered negative
for TB.
The diagnosis of LTBI is based on a positive
screening result in patients with a medical
history and physical examination consistent
with latent disease, once active TB has
been excluded.
If screening for LTBI is positive, it is still
necessary to exclude active TB prior to
starting treatment for LTBI because
neither screening test can differentiate
between active and latent infection.

11. TREATMENT  The primary goal of
the treatment
of latent TB is to
prevent reactivation
to active TB.
 Do not start
treatment with a
single-drug regimen
until active TB has
been ruled out with
negative cultures.
 Rifampin and rifapent
ine are not
interchangeable and
clinicians and
pharmacists should
be careful to
prescribe and
administer the
correct drug.
DETAILED REGIMEN INDICATION
SHORT REGIM
ENS
• Once-weekly isoniazid PLUS
once-weekly rifapentine for 3
months (abbreviation: 3HP)
• PLUS pyridoxine (for all
individuals at risk
of peripheral
neuropathy from INH)
• Once-daily rifampin for 4
months
• Most patients > 2
years of age
• Select patients
with HIV/AIDS
• HIV negative
patients of any age
who:
• Are unable to
tolerate INH
• OR have been
exposed to INH-
resistant TB
LONG
REGIMENS
• Once-daily isoniazid for 6
months (abbreviation: 6H)
• Once-daily isoniazid for 9
months (abbreviation: 9H)
• PLUS pyridoxine (for all
individuals at risk
• Most patients
with HIV
• Patients of any age
with
contraindications
for rifamycins

12. L ATENT TB VS ACTIVE TB