Recent Advances in the Treatment of Latent Tuberculosis Infection Among Adults Living with HIV Infection

Abstract

In this chapter, we review evidence supporting the tuberculosis (TB) disease spectrum, rather than dichotomous categories of latent M. tuberculosis infection (LTBI) and active disease, as TB pathophysiology is important when considering TB prevention and treatment. We also describe the impact of immunocompromising conditions, specifically human immunodeficiency virus (HIV) infection, along the TB disease spectrum. We review the indications for treatment of LTBI among people living with HIV (PLWH) and the evidence behind the LTBI treatment regimens currently recommended by the World Health Organization and the United States Centers for Disease Control and Prevention. Lastly, we discuss the importance of antiretroviral therapy (ART) in addition to anti-mycobacterial therapy for the prevention of TB among PLWH, as well as the drug-drug interactions with concomitant antiretroviral therapy and LTBI treatment.