image by: Jasso Lamberg

HWN Suggests

Conditional expanding post-exposure prophylaxis: a potential new tool for tuberculosis control

At present, chemoprophylaxis is the most common tool for TB PEP. Although the efficacy of currently available TB preventive treatment regimens (ranges from 60% to 90%) works well, drug-related adverse events and incompliance should not be ignored. As the potential benefit of preventive treatment should be carefully balanced against the risk for drug-related adverse events, great hopes are placed on immunotherapy which might have better safety and compliance. The Vaccae vaccine is a specified lysate that has been licensed by the China Food and Drug Administration as an immunotherapeutic agent. Currently, it is the only vaccine approved by the WHO that has completed a phase III trial to examine…

read full article

Featured

 Tuberculosis (TB) exposure

If you are told you have been in contact with someone who has active tuberculosis (TB) disease, you probably have a lot of questions.

Articles of Interest

One-Month Tuberculosis Prophylaxis as Effective as Nine-Month Regimen for People Living with HIV

A one-month antibiotic regimen to prevent active tuberculosis (TB) disease was at least as safe and effective as the standard nine-month therapy for people living with HIV, according to the results of a large international clinical trial. Adults and adolescents in the trial were more likely to complete the short-course regimen—consisting of daily doses of the antibiotics rifapentine and isoniazid for four weeks—than the standard nine-month regimen of daily isoniazid.

Post-exposure prophylaxis and tuberculosis prevention

As a widely used effective tool in preventing infectious diseases, post-exposure prophylaxis (PEP) has not yet been systematically applied in tuberculosis control. Currently, children aged < 5 years with close contacts to microbiologically confirmed tuberculosis patients was the only target population recommended to initiate PEP with anti-tuberculosis agents. The present study illustrated the application of PEP in preventing infectious diseases.

Responding to the post-pandemic crisis: post-exposure prophylaxis for TB

Recent research supports the PEP-TB rationale. In vitro studies have shown that latent M. tuberculosis bacilli are less susceptible to antibiotics,23 suggesting that treating for a shorter time immediately after a presumed exposure to M. tuberculosis could heal the infection before the latency phase.

Treatment of High-Risk Contacts

Sometimes treatment for latent TB infection (LTBI) is given to people even if they have a negative TB blood test or TB skin test result. For example, high-risk contacts may be given treatment for LTBI even if they have a negative TB blood test or TB skin test result if less than 8 to 10 weeks have passed since they were last exposed to TB. This practice is called window prophylaxis. Treatment is given because it can take 2 to 8 weeks after TB infection for the body’s immune system to be able to produce a response to a TB blood test or TB skin test.

Tuberculosis: Post-Exposure Testing and Management

The current recommendation for people exposed to highly contagious active TB source is to complete testing at baseline (when the source was confirmed with active TB) and again eight to 10 weeks after exposure has ceased.

Window Prophylaxis

Patients exposed to active TB should be evaluated by TST or IGRA, history and physical exam. If the TST / IGRA is negative and there are no symptoms of active tuberculosis, consideration should be given to treating the patient with isoniazid prophylaxis. The purpose of window prophylaxis is to abort an early TB infection and prevent progression to tuberculosis (it can take up to 3 months for the TST / IGRA to become positive after infection).

Window Prophylaxis [and other stuff involving tuberculosis in chidren

Window prophylaxis is indicated in TB-exposed children <4 years of age ...