Immunocompromised patients are at risk of TB
Overall, about 5–10% of people with latent TB infection will develop active TB disease at some time in their lives. The risk of active TB is greater in people suffering from conditions that impair the immune system.
- People who are infected with HIV are 16 times more likely to develop active TB (1).
- TB is the leading cause of death among HIV-infected patients (2).
- Patients receiving biologic (anti-TNF-α) therapy are at a 9-fold increased relative risk of developing active TB (3).
Let’s see how systematic latent TB testing and treatment can prevent the progression of latent TB to TB disease in immunocompromised patients.
Ensure peace of mind for people with HIV
As a result of immunosuppression, people living with HIV are at increased risk for TB, and reliable surveillance is critical to protect their health.
Thus, timely diagnosis and early treatment are vital to preventing its progression to disease. The WHO recommends systematic latent TB testing and treatment for all persons living with HIV – regardless of country incidence or income (4).
Protect patients receiving biologic therapy
Treatment with biologic agents, in particular tumor necrosis factor-alpha (TNF-α) inhibitors, has revolutionized the treatment of autoimmune conditions like rheumatoid arthritis, Crohn’s disease and psoriasis.
However, patients receiving anti-TNF-α therapy are at increased risk of TB infection. The immune system, including TNF, suppresses latent TB infection, but when treated with anti-TNF-α, the immune system may lose control over TB infection, leading to TB activation.
To reduce this risk, the WHO recommends latent TB testing in patients starting biologics (4).
The WHO recommends IGRA testing using QuantiFERON technology
- World Health Organization. (2022) WHO Tuberculosis Key Facts. https://www.who.int/news-room/fact-sheets/detail/tuberculosis (accessed January 15, 2023)
- Machuca, I., Vidal, E., de la Torre-Cisneros, J., Rivero-Román, A. (2018). Tuberculosis in immunosuppressed patients. Enferm Infecc Microbiol Clin. 36(6), 366–374.
- Lobue, P. and Menzies, D. (2010) Treatment of latent tuberculosis infection: An update. Respirology. 15, 603.
- World Health Organization. (2020) WHO consolidated guidelines on tuberculosis: tuberculosis preventive treatment. https://www.who.int/publications/i/item/who-consolidated-guidelines-ontuberculosis-module-1-prevention-tuberculosis-preventive-treatment