CDC Issues New TB Treatment Guidelines

They're aimed at shortening, simplifying the regimen used to prevent active disease

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By Robert Preidt

Thursday, December 8, 2011 HealthDay Logo

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Tuberculosis

THURSDAY, Dec. 8 (HealthDay News) -- New guidelines on treating so-called "latent" tuberculosis infection in the United States should significantly shorten and simplify the course of the therapy from about 9 months to 3 months, according to the U.S. Centers for Disease Control and Prevention.

The new guidelines for public health officials and health care providers -- which are based on expert opinion and the results of three clinical trials -- are a "game changer" for the treatment of TB in the United States, according to CDC Director Dr. Thomas Frieden.

Latent TB infection occurs when a person is infected with TB bacteria but does not yet have symptoms and so cannot transmit the bacteria to others. However, if the bacteria becomes active, the person will develop the disease and can also spread it to others.

Certain people, including those with weakened immune systems, are more likely to progress from latent to active TB. The CDC notes, however, that many high-risk people with latent TB feel fine and don't begin the nine-month course of treatment, which typically requires 270 daily doses of the anti-TB drug isoniazid. And many of those who do begin the therapy don't see it through to the end.

However, the new regimen streamlines the treatment to 12 once-per-week doses of isoniazid, along with another anti-TB drug called rifapentine.

"This regimen has the potential to be a game-changer in the United States when it comes to fighting TB," Frieden said in a CDC news release. "It gives us a new, effective option that will reduce by two-thirds -- from nine months to three months -- the length of time someone needs to take medicine to prevent latent TB infection from progressing to active TB disease."

The new guidelines were published in the Dec. 9 issue of the CDC's Morbidity and Mortality Weekly Report.

"If we are going to achieve our goal of TB elimination in the United States, we must ensure that those with latent TB infection receive appropriate evaluation and treatment to prevent their infection from progressing to TB disease and possibly spreading to others," Dr. Kevin Fenton, director of CDC's National Center for
HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in the news release.

"It is critical that we accelerate progress against TB in the United States in order to avoid a resurgence of the disease," he added.

The number of people in the United States with TB remains at an all-time low, with just over 11,000 cases reported in 2010. However, about 4 percent of the U.S. population (11 million people) are infected with the
TB bacterium. The CDC also noted that foreign-born people and people of color in the United States are disproportionately affected by the illness.

These new guidelines apply only to the United States, CDC officials said. Further research is likely needed before this regimen could be recommended for countries with a high incidence of TB, particularly those that have high rates of HIV and where there's a greater risk of TB re-infection.

SOURCE: U.S. Centers for Disease Control and Prevention, news release, Dec. 8, 2011

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