Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Treatment of Latent Tuberculosis Infection in Korea

국내에서 잠복결핵의 치료

  • Shim, Tae Sun (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Koh, Won Jung (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yim, Jae Joon (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine) ;
  • Lew, Woo Jin (Korean Institute of Tuberculosis)
  • 심태선 (울산대학교 의과대학 서울아산병원 호흡기내과) ;
  • 고원중 (성균관대학교 의과대학 내과학교실 삼성서울병원 호흡기내과) ;
  • 임재준 (서울대학교 의과대학 내과학교실 및 폐 연구소) ;
  • 류우진 (결핵연구원)
  • Published : 2008.08.30
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Abstract

국내에서 아직 잠복결핵 치료 대상 및 치료 방법에 대한 명확한 지침이 부족한 실정이며 이를 위해서는 잠복감염의 재활성화 혹은 새로운 감염이 어느 정도 결핵 발병의 원인이 되는지에 대한 연구가 선행되어야 한다. 그렇지만 발병의 위험이 높은 군을 선정하여 잠복결핵의 치료 대상으로 정하는 것이 타당할 것이며, 현재는 HIV 감염자, 전염성 결핵환자 가족 중 6세 미만의 아동, 중학생 및 고등학생에서의 집단 발병시 감염된 것으로 판정된 학생 및 종양괴사인자(tumor necrosis factor, TNF) 길항제 사용 예정인 잠복결핵 환자가 잠복결핵의 치료 대상으로 제한되어 있다. 향후에는 잠복결핵 치료 대상자의 확대가 필요할 것으로 생각되며, 치료방법 또한 isoniazid (INH) 단독 요법 이외에 rifampicin (RMP)을 포함하는 단기 요법의 사용도 고려하여야 하겠다. 현재 외국에서 잠복결핵의 치료법으로 권고되고 있는 것은 INH 6~9개월, RMP 4~6개월, INH/RMP 3개월 등이다. 과거부터 잠복결핵의 진단에 사용되어 온투베르쿨린 검사 외에 체외 인터페론감마 검사가 새로이 개발되면서 잠복결핵의 진단이 더 정확해진다면 이에 따라 잠복결핵 치료 방침도 수정될 가능성이 있으므로 새로운 검사법을 이용한 꾸준한 연구가 필요할 것이다.

Keywords

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