Download Screening for Latent Tuberculosis Infection

Understanding Task Force
Draft Recommendations
This fact sheet explains the Task Force’s draft recommendation statement on screening for latent tuberculosis infection. It also tells you
how you can send comments about the draft statement to the Task Force. Comments may be submitted from March 8 to April 4,
2016. The Task Force welcomes your feedback.
Screening for Latent Tuberculosis Infection
The U.S. Preventive Services Task Force (Task Force) has
issued a draft recommendation statement on Screening
for Latent Tuberculosis Infection.
This draft recommendation statement applies to adults
ages 18 and older who are at increased risk for latent
tuberculosis infection (LTBI) but who do not have
symptoms of TB. It does not apply to children and
adolescents or adults with symptoms of TB.
What is tuberculosis?
The Task Force reviewed research studies on the potential
benefits and harms of screening for latent TB infection.
The draft recommendation statement summarizes what
the Task Force learned: Adults at increased risk for LTBI
should be screened.
Tuberculosis (TB) is a serious infectious disease caused by the
Mycobacterium tuberculosis bacterium. It most commonly affects the lungs.
Latent TB happens when a person is infected with TB but the bacteria
are inactive. The person does not have symptoms and cannot pass on the
infection to other people.
Facts about Tuberculosis
TB can be spread from person to person through the air. When a person who is infected with TB coughs or sneezes,
droplets containing TB bacteria go out into the air. If another person inhales these bacteria, three things can happen:
•
The person’s immune system immediately destroys the TB bacteria and the person stays healthy.
•
The person becomes infected with TB and shows symptoms of active disease. The person can pass on the disease to
someone else.
•
The person becomes infected with TB, but the disease is inactive. The person shows no symptoms of TB, does not feel
sick, and cannot pass on the disease to anyone else. In this case, the person has LTBI. However, if left untreated, LTBI can
progress to active disease and the person can pass on the disease to someone else.
The general symptoms of TB disease include feeling sick or weak, weight loss, fever, and night sweats. When TB affects the lungs,
symptoms include coughing, chest pain, and coughing up blood.
TB infection is one of the most common infectious diseases in the world. It is less common in the United States, but many people
still become infected every year and are at risk of spreading the infection to others. About 9,420 cases of TB were reported in the
United States in 2014.
Comment Period from March 8 to April 4, 2016
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Screening for Latent Tuberculosis Infection
People who are increased risk of LTBI include:
•
Those who were born in, or who lived in, foreign countries where TB is common. These countries include Mexico, the Philippines,
Vietnam, India, China, Haiti, and Guatemala.
•
People who currently, or used to, live in large group settings, such as homeless shelters or prisons and jails, also are at increased
risk of being exposed to TB.
There are also other people who are at increased risk of developing TB, including people with weakened immune systems. Talk with
your doctor if you have questions.
Screening for Latent Tuberculosis Infection
Two types of screening tests are generally used for LTBI:
•
Tuberculin skin test. Patient receives a small injection underneath the skin, and returns in 2-3 days to have the skin test read.
•
IGRA. A blood test that requires only one health care visit.
If a person has a positive reaction to either test, additional follow-up tests are needed to determine whether the person has active TB or
latent TB.
Potential Benefits and Harms of Screening for Latent Tuberculosis Infection
The goal of screening for LTBI is to find the infection before it progresses to active TB so that latent TB can be treated and active TB
prevented.
The Task Force reviewed studies on the benefits and harms of screening for latent TB infection. They found that screening tests can
accurately detect latent TB infection and that effective treatments are available that can prevent LTBI from becoming active TB.
The Task Force found no evidence of harms from screening and only small potential harms from treatment.
The Draft Recommendation on Screening for Latent Tuberculosis Infection: What Does It Mean?
Here are the Task Force’s draft recommendations on screening for latent TB infection. Recommendation statements have letter
grades. The grades are based on the quality and strength of the evidence about the potential benefits and harms of screening for this
purpose. They also are based on the size of the potential benefits and harms. Task Force recommendation grades are explained in
the box at the end of this fact sheet.
This is a Grade B recommendation statement. That means the Task Force is recommending the screening because it has more
potential benefits than potential harms for the overall population covered by the recommendation. The Notes explain key ideas.
Before you send comments to the Task Force, you may want to read the full draft recommendation statement. The statement
explains the evidence the Task Force reviewed and how it decided on the grade. Evidence documents provide more detail about the
studies the Task Force reviewed.
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Screening for Latent Tuberculosis Infection
Notes
1
The Task Force recommends screening for latent
1 screening
tuberculosis infection (LTBI) in populations that are at
increased risk. Grade B
Using a skin test or a blood
test to determine infection with
the TB bacterium.
latent tuberculosis
When the body is infected
with TB but the bacteria are
inactive. The person has no
symptoms and cannot infect
another person.
at increased risk
People who were born in or
who lived in countries where
TB is common and people who
live in, or have lived in large
group settings where exposure
to TB is more likely.
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Screening for Latent Tuberculosis Infection
What is the U.S. Preventive Services Task Force?
The Task Force is an independent, volunteer panel of national experts in prevention and
evidence-based medicine. The Task Force works to improve the health of all Americans
by making evidence-based recommendations about clinical preventive services, such as
screenings, counseling services, or preventive medicines. The recommendations apply to
people with no signs or symptoms of the disease being discussed.
To develop a recommendation statement, Task Force members consider the best
available science and research on a topic. For each topic, the Task Force posts draft
documents for public comment, including a draft recommendation statement. All
comments are reviewed and considered in developing the final recommendation
statement. To learn more, visit the Task Force Web site.
USPSTF Recommendation Grades
Grade
Definition
A
Recommended.
B
Recommended.
C
Recommendation depends on the patient’s situation.
D
Not recommended.
I statement
Click Here to Learn More
About Tuberculosis
The Difference Between
Latent TB Infection and
TB Disease (Centers
for Disease Control
and Prevention)
Tuberculosis
(MedlinePlus)
Tuberculosis (National
Institute of Allergy and
Infectious Disease)
There is not enough evidence to make a recommendation.
Click Here to Comment on the Draft Recommendation
March 8 April 4, 2016
The Task Force welcomes comments
on this draft recommendation.
Comment Period from March 8 to April 4, 2016
Comments must be received between
March 8 and April 4, 2016.
All comments will be considered for
use in writing final recommendations.
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