Treatment of latent TB Infection and the risk of tuberculosis after solid organ transplantation: Comprehensive review.
Transpl Infect Dis
; 21(6): e13178, 2019 Dec.
Article
em En
| MEDLINE
| ID: mdl-31541575
ABSTRACT
BACKGROUND:
Mycobacterium tuberculosis disease may occur after treatment of latent TB infection (LTBI). Prompted by a case of reactivation TB disease in a solid organ transplant (SOT) recipient who received LTBI treatment, we reviewed the literature to examine outcomes, adverse effects, resistance, and treatment choices of tuberculosis after LTBI therapy.METHODS:
MEDLINE and Web of Science from inception to 5/2019 were reviewed using key words "latent tuberculosis infection" and "SOT" or "transplantation." The search yielded nine cases, 41 cohort studies and six randomized controlled trials (RCT).RESULTS:
Cohort and RCT demonstrated significant reduction in TB disease among transplanted patients who received LTBI therapy; only 56/2651 (2.1%) SOT patients developed TB after LTBI therapy. Adverse drug reactions occurred in 149/1148 (12.9%) and 73/641 (11.4%) of cohort and RCT patients, respectively. Among liver recipients, 56/266 (21%) developed side effects, of which half (29/56, 51.8%) was INH-related. There was no reported INH resistance.CONCLUSIONS:
Latent TB infection treatment is efficacious in SOT recipients at risk of TB disease. However, tuberculosis may still occur despite LTBI treatment. Hepatotoxicity associated with LTBI therapy is infrequent, although more commonly observed among liver recipients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
3_ND
Base de dados:
MEDLINE
Assunto principal:
Transplante de Órgãos
/
Tuberculose Latente
/
Doença Hepática Induzida por Substâncias e Drogas
/
Mycobacterium tuberculosis
/
Antituberculosos
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
País/Região como assunto:
Africa
/
America do norte
Idioma:
En
Revista:
Transpl Infect Dis
Ano de publicação:
2019
Tipo de documento:
Article