Pulmonology Book


Tuberculosis Risk Factors for progression from Latent to Active Disease

Aka: Tuberculosis Risk Factors for progression from Latent to Active Disease, Tb Risk Factors for Latent Disease Progression, Latent Tuberculosis Treatment Indications
  1. See Also
    1. Tuberculosis
    2. Latent Tuberculosis Treatment
    3. Tuberculosis Risk Factors (Tuberculosis Screening Indications)
  2. Risk Factors: Progression from active to latent disease (indications for Latent Tuberculosis Treatment)
    1. Age under 5 years old
    2. Medically underserved or low income groups (especially if homeless)
    3. Substance Abuse
      1. Alcoholism
      2. Intravenous Drug Abuse (or other Illicit Drug abuse)
    4. Recent contact of a person known to have Active Tuberculosis
    5. Recent latent infection with Tuberculosis (with PPD conversion within last 2 years)
    6. History of untreated or inadequately treated Active Tuberculosis
      1. Chest XRay with healed Tb-related fibrotic changes (especially apical fibronodular scarring)
      2. Other findings suggestive of previous Tuberculosis
    7. Immunosuppressive Disease (or other predisposing condition)
      1. Human Immunodeficiency Virus (HIV) or AIDS (100 fold increased risk)
      2. Diabetes Mellitus (30% lifetime risk of progression)
      3. End Stage Renal Disease (requiring Dialysis)
      4. Leukemia
      5. Lymphoma
      6. Head and neck cancer
      7. Lung Cancer
      8. Low body weight (10% or more below Ideal Weight)
      9. Intestinal bypass or gastrectomy (Bariatric Surgery)
      10. Chronic lung disease
        1. Lung parenchyma abnormalities in smokers
        2. Silicosis
    8. Immunosuppressive Therapy
      1. Tumor Necrosis Factor agents
      2. Prolonged Corticosteroids (Prednisone 15 mg daily or equivalent)
      3. Immunosuppression following organ transplant (especially heart or Kidney)

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