CDC Updates Guidelines on Weekly Therapy for Latent TB Infection

By Amy Orciari Herman

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

The CDC has expanded its recommendations for short-course combination therapy for latent tuberculosis infection.

Previously, the agency recommended once-weekly isoniazid and rifapentine for 12 weeks by directly observed therapy for adults with latent TB, including those with HIV who weren't taking antiretroviral therapy. Now, the regimen is also advised in the following scenarios:

• For patients aged 2 to 17 years. In a randomized trial, this regimen was as effective as 9 months of daily isoniazid, was safe, and had higher completion rates.

• For patients with HIV, including those with AIDS, who are taking antiretrovirals, provided the potential interactions with rifapentine are deemed acceptable. Data indicate there are no clinically significant interactions between once-weekly rifapentine and efavirenz or raltegravir.

• Given as self-administered therapy in patients aged 2 years and older. Clinicians should consider numerous factors when choosing between self-administered and directly observed therapy, including the patient's risk for progression to severe TB.