The Korean Journal of Medicine

  • 제93권6호
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  • Pages.509-517
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  • 2018
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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잠복결핵의 진단과 치료: 2017 개정 지침을 중심으로

Diagnosis and Treatment of Latent Tuberculosis Infection: The Updated 2017 Korean Guidelines

  • 이승헌 (고려대학교 의과대학 내과학교실)
  • Lee, Seung Heon (Department of Internal Medicine, Korea University College of Medicine)
  • 투고 : 2018.10.18
  • 심사 : 2018.11.07
  • 발행 : 2018.12.01
⟨ 이전 논문 다음 논문 ⟩

초록

A small number of viable tuberculosis bacilli can reside in an individual with latent tuberculosis infection (LTBI) without obvious clinical symptoms or abnormal chest radiographs. Diagnosis and treatment of LTBI are important for tuberculosis (TB) control in public and private healthcare facilities, particularly in high-risk populations. The updated 2017 Korean guidelines for TB recommend that tuberculin skin tests, interferon-gamma release assays, or a combination of them can be used for the diagnosis of LTBI, depending on the age and immune status of the patient as well as their TB contact history. For diagnosis of LTBI, exclusion of active TB is essential, and the possibility of healed TB in those without a history of treatment for TB but at risk of its development must be considered. The treatment options for LTBI include isoniazid, rifampicin, isoniazid/rifampicin, and isoniazid/rifapentine. The benefits and risks of these agents based on the age of the patient and their hepatotoxicity must be considered when selecting the appropriate drug. Standardized diagnosis and treatment of LTBI based on the updated 2017 guidelines will contribute to the control of TB in Korea as well as to further revisions of the guidelines.

키워드

참고문헌

  1. Frieden TR, Sterling TR, Munsiff SS, Watt CJ, Dye C. Tuberculosis. Lancet 2003;362:887-899. https://doi.org/10.1016/S0140-6736(03)14333-4
  2. WHO. Global tuberculosis control. Geneva: World Health Organization, 2011.
  3. WHO. Global tuberculosis report 2017. Geneva: World Health Organization, 2018.
  4. Lewinsohn DM, Leonard MK, LoBue PA, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis 2017;64:e1-e33. https://doi.org/10.1093/cid/ciw694
  5. National Institute for Health and Clinical Excellence (NICE). Clinical guideline 33. Tuberculosis. Clinical diagnosis and management of Tuberculosis, and Measures for its Prevention and Control [Internet]. London (UK): NICE, c2016 [cited 2018 Oct 1] Available from: http://www.nice.org.uk/ guidance/ng33.
  6. Joint Committee for the Revision of Korean Guidelines for Tuberculosis & Korea Centers for Disease Control and Prevention. Korean Guidelines for Tuberculosis [Internet]. Seoul (KR): Korea Centers for Disease Control and Prevention, c2011 [cited 2018 Oct 1]. Available from: http://tbzero.cdc.go.kr/tbzero/main.do.
  7. Joint Committee for the Revision of Korean Guidelines for Tuberculosis & Korea Centers for Disease Control and Prevention. Korean Guidelines for Tuberculosis [Internet]. Seoul (KR): Korea Centers for Disease Control and Prevention, c2017 [cited 2018 Oct 1]. Available from: http://www.lungkorea.org/bbs/?code=guide.
  8. Hong YP, Kim SJ, Lew WJ, Lee EK, Han YC. The seventh nationwide tuberculosis prevalence survey in Korea, 1995. Int J Tuberc Lung Dis 1998;2:27-36.
  9. Choi CM, Kang CI, Kim DH, et al. The role of TST in the diagnosis of latent tuberculosis infection among military personnel in South Korea. Int J Tuberc Lung Dis 2006;10:1342-1346.
  10. Lee JY, Choi HJ, Park IN, et al. Comparison of two commercial interferon-gamma assays for diagnosing Mycobacterium tuberculosis infection. Eur Respir J 2006;28:24-30. https://doi.org/10.1183/09031936.06.00016906
  11. Lee SW, Oh SY, Lee JB, Choi CM, Kim HJ. Tuberculin skin test distribution following a change in BCG vaccination policy. PLoS One 2014;9:e86419. https://doi.org/10.1371/journal.pone.0086419
  12. Targeted tuberculin testing and treatment of latent tuberculosis infection. This official statement of the American thoracic society was adopted by the ATS board of directors, July 1999. This is a joint statement of the American thoracic society (ATS) and the centers for disease control and prevention (CDC). This statement was endorsed by the council of the infectious diseases society of America. (IDSA), September 1999, and the sections of this statement. Am J Respir Crit Care Med 2000;161(4 Pt 2):S221-S247. https://doi.org/10.1164/ajrccm.161.supplement_3.ats600
  13. Solovic I, Sester M, Gomez-Reino JJ, et al. The risk of tuberculosis related to tumour necrosis factor antagonist therapies: a TBNET consensus statement. Eur Respir J 2010;36:1185-1206. https://doi.org/10.1183/09031936.00028510
  14. Metcalfe JZ, Cattamanchi A, McCulloch CE, Lew JD, Ha NP, Graviss EA. Test variability of the QuantiFERON-TB gold in-tube assay in clinical practice. Am J Respir Crit Care Med 2013;187:206-211. https://doi.org/10.1164/rccm.201203-0430OC
  15. Pulblic Health Agency of Canada. Canadian tuberculosis standard. 7th Ed. Vancouver: Centre for Disease Control, 2014.
  16. Mazurek GH, Jereb J, Vernon A, et al. Updated guidelines for using interferon gamma release assays to detect mycobacterium tuberculosis infection - United States, 2010. MMWR Recomm Rep 2010;59(RR-5):1-25.
  17. National Tuberculosis Controllers Association; Centers for Disease Control and Prevention (CDC). Guidelines for the investigation of contacts of persons with infectious tuberculosis. Recommendations from the national tuberculosis controllers association and CDC. MMWR Recomm Rep 2005;54(RR-15):1-47.
  18. Menzies D, Adjobimey M, Ruslami R, et al. Four months of rifampin or nine months of isoniazid for latent tuberculosis in adults. N Engl J Med 2018;379:440-453. https://doi.org/10.1056/NEJMoa1714283
  19. Spyridis NP, Spyridis PG, Gelesme A, et al. The effectiveness of a 9-month regimen of isoniazid alone versus 3- and 4-month regimens of isoniazid plus rifampin for treatment of latent tuberculosis infection in children: results of an 11-year randomized study. Clin Infect Dis 2007;45:715-722. https://doi.org/10.1086/520983
  20. Sterling TR, Villarino ME, Borisov AS, et al. Three months of rifapentine and isoniazid for latent tuberculosis infection. N Engl J Med 2011;365:2155-2166. https://doi.org/10.1056/NEJMoa1104875
  21. Kim SH, Lee SO, Park JB, et al. A prospective longitudinal study evaluating the usefulness of a T-cell-based assay for latent tuberculosis infection in kidney transplant recipients. Am J Transplant 2011;11:1927-1935. https://doi.org/10.1111/j.1600-6143.2011.03625.x
  22. Kim SY, Jung GS, Kim SK, et al. Comparison of the tuberculin skin test and interferon-${\gamma}$ release assay for the diagnosis of latent tuberculosis infection before kidney transplantation. Infection 2013;41:103-110. https://doi.org/10.1007/s15010-012-0291-0
  23. Kim SH, Lee SO, Park IA, et al. Diagnostic usefulness of a T cell-based assay for latent tuberculosis infection in kidney transplant candidates before transplantation. Transpl Infect Dis 2010;12:113-119. https://doi.org/10.1111/j.1399-3062.2010.00495.x
  24. Jo KW, Hong Y, Park JS, et al. Prevalence of latent tuberculosis infection among health care workers in South Korea: a multicenter study. Tuberc Respir Dis (Seoul) 2013;75:18-24. https://doi.org/10.4046/trd.2013.75.1.18
  25. Kim SJ, Lee SH, Kim IS, Kim HJ, Kim SK, Rieder HL. Risk of occupational tuberculosis in national tuberculosis programme laboratories in Korea. Int J Tuberc Lung Dis 2007;11:138-142.
  26. Korea Centers for Disease Control and Prevention. 2018 manual of national tuberculosis control [Internet]. Osong (KR): Korea Centers for Disease Control and Prevention, c2018 [cited 2018 Oct 1]. Available from: http://tbzero.cdc.go.kr/tbzero/main.do.

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