III. Treatment of Latent TB Infection (LTBI)
Last Updated April 2026
Treatment of LTBI is recommended for persons who are at increased risk for developing active TB disease following infection with Mycobacterium tuberculosis. Those at increased risk for progression to active TB disease are outlined in Table 3 and include persons living with HIV, those who are immunosuppressed and/or receiving immunosuppressive therapy (or scheduled to receive immunosuppressive therapy including TNF-α inhibitors or other biologic agents), close contacts of persons with infectious active TB disease (e.g., pulmonary TB), others who are thought to have recent infection with M. tuberculosis (e.g., persons who have had a conversion from a negative to a positive diagnostic test for LTBI within the previous 2 years), immigrants and refugees from high TB burden countries, and children at risk who are < 5 years old.
The risk of serious disease, including miliary or disseminated TB and tuberculous meningitis, is highest among persons living with HIV, especially if they have advanced HIV/AIDS. Infants, the elderly, and patients with other causes of severe immunosuppression are also at increased risk for disseminated TB disease. Treatment for LTBI should be started only if clinical and radiographic evaluations exclude active TB disease. Persons with LTBI who are considered to be at high risk for developing active TB (see Table 3) should be offered (and encouraged to take) treatment for LTBI regardless of age.