Latent TB Treatment in OB

Dr. Chapa’s Clinical Pearls.

Tuberculosis (TB) was historically called "consumption" due to the dramatic weight loss and wasting away experienced by patients. The modern name "tuberculosis" was first published by J. L. Schönlein in 1832. Today, between 3% and 5% of the U.S. population are estimated to be living with latent TB infection. Contrast that with the worldwide statistics which state that nearly one fourth of the world population has TB infection. In some countries in sub-Saharan Africa and Asia, the annual incidence is several hundred per 100,000 population. In the US, the annual incidence is <3 per 100,000 population, but immigrants from countries with a high TB burden and long-term residents of high-burden countries have a 10× greater incidence of TB than the US national average. Thankfully, only 5–10% of individuals with latent TB infection will progress to active TB disease over their lifetimes. But it is difficult to predict who will progress from latent TB infection to active TB disease. The perinatal period is a good opportunity to screen, diagnose, and treat those at high risk for TB. The ACOG the American Academy of Pediatrics, and the Centers for Disease Control and Prevention (CDC) recommend screening all women who are at high risk for TB at the initiation of antenatal care. In this episode, we will review the epidemiology of tuberculosis, who should be screened, and focus on latent TB infection management in pregnancy. What does the “4R” preferred regimen mean? Listen in and find out.