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A positive IGRA result may not necessarily indicate TB infection, but can also be caused by infection with non-tuberculous mycobacteria. A negative IGRA does not rule out active TB disease; a number of studies have shown that up to a quarter of patients with active TB have negative IGRA results.
T-SPOT.TB, a form of ELISpot, the variant of ELISA (licensed in Europe, US, Japan and China). [3] The former test quantitates the amount of IFN-γ produced in response to the ESAT-6 and CFP-10 antigens from Mycobacterium tuberculosis, which are distinguishable from those present in BCG and most other non-tuberculous mycobacteria.
Management of tuberculosis refers to techniques and procedures utilized for treating tuberculosis (TB), or simply a treatment plan for TB. The medical standard for active TB is a short course treatment involving a combination of isoniazid , rifampicin (also known as Rifampin), pyrazinamide , and ethambutol for the first two months.
Aspergilloma in an old tuberculosis cavity; healed, calcified tuberculous lesions are also present towards the right of the image Healed tuberculous cavity, where the entire left lung is destroyed. Post-tuberculosis lung disease (PTLD) is ongoing lung disease that is caused by tuberculosis (TB) but persists after the infection is cured. [1]
Treatment of latent TB infection typically involves using a single drug for a prolonged period of time—the most common approach is Isoniazid for 9 months. Treatment of active TB disease is typically a combination of antibiotics, which results in patients being non-infectious to others usually within a few weeks.
Treatment regimens outside a clinical trial should include at least two agents. Every regimen should contain either azithromycin or clarithromycin; many experts prefer ethambutol as a second drug. Many clinicians have added one or more of the following as second, third, or fourth agents: clofazimine, rifabutin, rifampin, ciprofloxacin, and in ...
In people with smear-positive pulmonary TB (without HIV co-infection), after 5 years without treatment, 50–60% die while 20–25% achieve spontaneous resolution (cure). TB is almost always fatal in those with untreated HIV co-infection and death rates are increased even with antiretroviral treatment of HIV. [168]
As such, a person diagnosed with latent TB can safely assume that, even after treatment, they will carry the bacteria – likely for the rest of their lives. Furthermore, "It has been estimated that up to one-third of the world's population is infected with M. tuberculosis, and this population is an important reservoir for disease reactivation."