Image of 3HP TB drug combo

Publication title: WHO Latent TB infection guidelines updated and consolidated

Author(s): World Health Organisation (WHO)

Publication date: 2020

What:

These guidelines provide a consolidated and updated response from the World Health Organisation (WHO) on the treatment and management of latent tuberculosis infection (LTBI). These latest guidelines broaden the application of previous WHO documents on LTBI in at-risk groups. 

Key take-aways:

  • The WHO recommends that adults and young people living with HIV who are unlikely to have active TB should still receive preventive TB treatment. This is a strong recommendation from the WHO, which considers this part of a comprehensive HIV treatment package.
  • An additional recommendation from the Organisation concerns children living in homes with people with bacteriologically confirmed TB. These children, younger than 5 years, should receive preventive TB treatment, the WHO proposes. This applies irrespective of HIV status.
  • The WHO suggests using a clinical algorithm, or set of rules, in identifying whether someone living with HIV has active TB or not. Should the person not report certain symptoms including “current cough, fever, weight loss or night sweats” they are considered as unlikely to have active TB. It is still recommended by the WHO that these individuals be placed on preventive TB treatment, irrespective of their antiretroviral treatment (ART) status.
  • People living with HIV and currently on ART should receive chest x-rays to test for and rule out active TB. Individuals should receive preventive treatment should their x-rays not produce any abnormal findings. 
  • In treating LTBI health professionals can prescribe a six or nine-month course of daily isoniazid, regardless of an individual’s HIV status. An alternative to this is a three-month programme of rifapentine and isoniazid, or 3HP, taken weekly. An additional alternative to treatment is the combination of isoniazid and rifampicin taken daily over three-months

You can find and download the updated guidelines here.