SOURCE: USPSTF. Screening for latent tuberculosis infection in adults: US Preventive Services Task Force recommendation statement. JAMA 2016;316:962-969.
The U.S. Preventive Services Task Force (USPSTF) recently issued a Level B recommendation endorsing screening for latent TB in high-risk populations, meaning, “there is high certainty that the net benefit is moderate, or there is moderate certainty that the net benefit is moderate to substantial.”
Based on screening using either the Mantoux tuberculin skin test or the interferon-gamma release assay, the USPSTF concluded that both are sufficiently sensitive and specific to be considered accurate. Despite the absence of TB screening trials that confirm benefits, since treatment of latent TB prevents progression to active TB, a moderate degree of benefit should be achieved through screening.
However, TB screening is not advocated on a population-wide basis. Instead, USPSTF recommends screening in high-risk populations. Such individuals include persons who have lived in countries of high TB prevalence (e.g., Mexico, Philippines, Vietnam, India, China, Haiti, or Guatemala), have lived in high-risk congregate settings (e.g., homeless/correctional facilities), are immunosuppressed (e.g., HIV or on immunosuppressive meds), and have been in contact with persons suffering from active TB.
Despite the absence of TB screening trials that confirm benefits, since treatment of latent TB prevents progression to active TB, a moderate degree of benefit should be achieved through screening.
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