CDC releases new TB treatment protocol

ATLANTA — The Centers for Disease Control and Prevention on Thursday released new recommendations to treat latent tuberculosis infection.

The new recommendations, published in CDC’s Morbidity and Mortality Weekly Report, provide guidance on how to administer a new 12-dose regimen for TB preventive therapy that will significantly shorten and simplify the course of treatment from about nine months to 12 weeks. The recommendations are based on the results of three clinical trials, as well as expert opinion.

“This regimen has the potential to be a game-changer in the United States when it comes to fighting TB,” CDC director Thomas Frieden said. “It gives us a new, effective option that will reduce by two-thirds — from nine months to three months — the length of time someone needs to take medicine to prevent latent TB infection from progressing to active TB disease.”

Latent TB infection occurs when a person has TB bacteria but does not have symptoms and cannot transmit the bacteria to others. In the United States, the number of persons with TB disease is at an all-time low (11,182 total cases were reported in 2010); however, approximately 4% of the U.S. population, or 11 million people, are infected with the TB bacterium. TB continues to disproportionately affect people of color and foreign-born persons in this country.

“If we are going to achieve our goal of TB elimination in the United States, we must ensure that those with latent TB infection receive appropriate evaluation and treatment to prevent their infection from progressing to TB disease and possibly spreading to others,” said Kevin Fenton, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.  “It is critical that we accelerate progress against TB in the United States in order to avoid a resurgence of the disease.”

The new 12-dose regimen adds another effective treatment option to the prevention toolkit for TB, and is not meant to replace other preventative treatment regimens for all patients where the new regimen is not the best option. The regimen includes 12 once-weekly doses of rifapentine and isoniazid. Doses should be taken under the supervision of a health care worker to ensure completion of doses and to allow for monitoring of safety among patients.