Get to know latent TB, asymptomatic TB bacterial infection

Latent tuberculosis infection (latent TB) is often not realized by the sufferer because it does not cause any symptoms. If not treated promptly, latent TB can develop into active tuberculosis (active TB).

The difference between active TB and latent TB is in the symptoms and transmission. Active TB is generally accompanied by symptoms, such as a cough that does not go away for more than 3 weeks with or without coughing up blood. People with active TB can also transmit TB bacteria to other people.

Get to know latent TB, asymptomatic TB bacterial infection

Meanwhile, patients with latent TB will not experience any symptoms and cannot transmit the Mycobacterium tuberculosis bacteria that causes TB to others.

Even though it does not cause symptoms, TB bacteria remain in the body of a latent TB patient in an inactive or "asleep" condition. If not treated, latent bacteria that "fall asleep" can become active and cause symptoms.

Latent TB Check

There are several groups that are known to be at high risk of developing latent TB, including:

  • Children living in areas with high TB ​​cases
  • People living with family members who are infected with active TB
  • People who live or work for more than 3 months with local residents in areas with high TB ​​case rates
  • Health care workers who are in close contact with active TB patients or clinical samples, such as sputum

Research shows that about 5–10% of TB bacterial infections can progress to active TB within the first 2–5 years. This means, proper TB screening and treatment needs to be done since the first infection occurs, to prevent the bacteria from developing into active TB.

There are several tests to diagnose latent TB. Two types of tests commonly used are the Mantoux test (tuberculin) and the molecular rapid test. The test is carried out according to availability at the nearest health service. Here is the explanation:

Mantoux test (tuberculin)

The Mantoux test is done by injecting a number of fluids containing tuberculosis bacteria into the skin, precisely on the underside of the arm. After 48–72 hours, the part of the skin that was injected with the liquid will be examined to determine the results.

If a small hard red lump appears in the injection site, the test result is positive for TB. Meanwhile, if the skin does not experience any changes to the Mantoux test performed, the test result is negative for TB.

Molecular rapid test (TCM)

A quick and easy diagnosis of latent TB can be made using the rapid molecular test (TCM). Within 2 hours, this tool can detect TB bacterial DNA and resistance to the antibiotic rifampin.

This TB screening can use several types of specimens, ranging from sputum, gastric lavage, feces, to cerebrospinal fluid.

In addition, latent TB can also be tested with an IGRA blood test (interferon gamma release assay) to measure the immune system's reaction to TB bacteria.

Typically, a blood test is done if you are at high risk of TB infection but have a negative Mantoux test, or have recently received the BCG vaccine. However, this examination cannot be carried out in all health services in Indonesia.

Latent TB Treatment

If the examination shows that you have latent TB, treatment needs to be done immediately to prevent the TB bacteria from developing into active TB. The following are drugs that are commonly prescribed to treat latent TB:

  • Isoniacid (INH)
  • Rifapentin (RPT)
  • Rifampicin (RIF)

In Indonesia, tuberculosis preventive therapy (TPT) to treat latent TB is carried out in the short term with the following guidelines:

  • Given INH and Rifapentin (3HP) every week for 3 months
  • Give daily INH and Rifampicin (3HR) for 3 months

However, this treatment should be changed if TB bacteria are transmitted from an individual with MDR TB. Not only that, the treatment of latent TB also needs to be adjusted to the medical conditions that accompany the patient, as well as the potential for drug interactions if the patient is taking other drugs.

Latent TB that is not treated immediately is at risk of becoming active TB. Therefore, immediately consult a doctor if you have close contact with an active TB patient so that you can get treatment, if latent TB is confirmed.

Keep in mind, treatment for latent TB and active TB should be carried out according to the doctor's directions. Discontinuation of TB treatment without a doctor's instruction can lead to MDR TB, which is TB that is resistant to various drugs making it difficult to cure, as well as cases of drug dropout TB.

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