Update of WHO guidelines on the management of latent TB infection

World Health Organization
July 1, 2019, 9:04 p.m.

01 July 2019 | Geneva: In July 2019, the World Health Organization (WHO) will convene a Guideline Development Group (GDG) to discuss what updates are needed to the current guidelines for programmatic management of latent tuberculosis infection (LTBI).

Scaling up effective LTBI treatment will be critical to driving down global TB incidence as envisaged by the End TB Strategy and achieving the 2022 target of reaching 30 million people with TB preventive treatment as committed in the political declaration of the UN high-level meeting on TB in 2018. A rapid scale-up of TB preventive treatment among populations at risk is therefore required.

WHO published its latest guidance on the programmatic management of LTBI in early 2018. Since then, results were published from two trials of shorter, rifamycin-containing LTBI treatment regimens, which included evidence from high TB burden settings. These findings are significant because the shortening of treatment can enhance the scalability of preventive treatment by improving adherence and possibly safety. In addition to the two trials, the GDG will also consider other evidence on measures to enhance the safety of TB preventive treatment in pregnancy.

The new guidelines are expected to be released in late 2019 (see more details in the background document here). Ahead of their finalization there will be an opportunity for those who were not directly involved in the guideline expert panels to comments on the new recommendations. If you are interested to contribute to this please send an email to latent_tb@who.int by 10 July. You can also send questions to the same email.

"The WHO’s Science division aims to ensure the excellence, relevance and timeliness of our guidelines", said Dr Soumya Swaminathan, WHO Chief Scientist. "We are happy that the Global TB Programme has agreed to be the first to test the revised processes of public consultation and expert decision making. We encourage all stakeholders to participate in the more inclusive and transparent process and to provide feedback on the experience".

One in four people in the world is estimated to have LTBI.

Someone with LTBI is infected with TB bacteria but does not have signs of active TB disease.

People with LTBI have a risk to develop active TB disease, becoming ill and putting them at risk of infecting others.

Source: WHO