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Latent tuberculosis infection (LTBI) is defined as a condition of a permanent immune response stimulated by tuberculosis mycobacteria (TB) antigens without the presence of a clinical manifest active disease It is estimated that 2 billion people, or one third of the world's population, are latently infected with TB bacteria During life, the risk of reactivation of TB in people with confirmed LTBI is 5-10%, and that most will develop illness during the first five years after the initial infection .The systematic detection and treatment of LTBI is an important component of the World Health Organization's new "End of TB" strategy (WHO). To diagnosis of latent tuberculosis infection both tests are used: Tuberculosis skin test (TST), and QuantiFERON-TB(QFT-Quantiferone) which belongs to the group of the IGRA tests (interferon -gama release assay). Indications for diagnosis and treatment are: family contacts from 0 to14 years, infants , children and adults carriers of HIV virus and other people with medical risk factors. For the treatment of LTBI, in our country, the standard 6 month regime with Isoniazid, and as an alternative, a 3 month regimen with Isoniazid and Rifampicin are administered. 9- month regime with Isoniazid is applied in people with HIV infection. In 2017, in our country, 45 people with LTBI were examined and treated. 41 (91%) were family contacts with pulmonary smear positive tuberculosis and in 4 (9%) who were with-medical risk factors for the treatment of LTBI (HIV positives, or people who were treated with anti-TNF therapy). For the diagnosis of LTBI, two tests were applied .In 9 (20%) QuantiFERON-TB and by all examined was positive, that confirms the fact of greater sensitivity in comparison with TST. At 41, TST was made, of which 20 or 46% was positive. The LTI treatment was implemented with two regimes , 24 (54%) were treated with a six- months daily regime with INH (Isoniazid), and 21 (46%) with a three-month daily regime with two anti-tuberculosis drugs (INH and Rifadin ). Those who were HIV positive treatment with INH were administered for 9 months. According to the outcome of the treatment, in 28 (62%) the treatment is completed, and in 17 (38%) was discontinued due to non-cooperation, and due to the control negative results of TST Conclusion: The diagnosis and successful treatment of LTBI is an important component of the new strategy for the WHO "End of TB". The low percentage of successfully treated persons with LTBI in our country, in 2017 (62.2%) imposes the need to improve the management of persons with LTBI, with the aim of achieving its eradication |
