The treatment of<unk>  infection <unk> I) is essential to controlling and eliminating TB by reducing the risk that TB infection will progress to disease.<unk>  will convert to active tuberculosis in 10% of cases (or more in cases of immune compromised patients). Taking medication for<unk>  is recommended by many doctors. In the U.S., the standard treatment is nine months of isoniazid, but this regimen is not widely used outside of the US. Terminology There is no agreement regarding terminology: the terms preventive therapy and chemoprophylaxis have been used for decades, and are preferred in the UK because it involves giving medication to people who have no disease and are currently well: the reason for giving medication is primarily to prevent people from becoming unwell. In the U.S., physicians talk about<unk>  treatment because the medication does not actually prevent infection: the person is already infected and the medication is intended to prevent existing silent infection from becoming active disease. There are no convincing reasons to prefer one term over the other. Specific situations "Populations at increased risk of progressing to active infection once exposed: * Persons with recent TB infection those infected within the previous two years * Congenital or acquired immunosuppressed patients (in particular, HIV-positive patients) * Illicit intravenous drug users; alcohol and other chronic substance users * Children (particularly those younger than 4 years old) * Persons with comorbid conditions (ie, chronic kidney failure, diabetes, malignancy, hematologic cancers, body weight of at least 10% less than ideal, silicosis, gastrectomy, jejunoileal bypass, asthma, or other disorders requiring long-term use of corticosteroids or other immunosuppressants)." Treatment regimens It is essential that assessment to rule out active TB be carried out before treatment for<unk> I is started. To give treatment for<unk>  to someone with active tuberculosis is a serious error: the tuberculosis will not be adequately treated and there is a serious risk of developing drug-resistant strains of TB. There are several treatment regimens currently in use: * 9H — isoniazid for 9 months is the gold standard (93% effective, in patients with positive test results and fibrotic pulmonary lesions compatible with tuberculosis). * 6H — Isoniazid for 6 months might be adopted by a local TB program based on cost-effectiveness and patient compliance. This is the regimen currently recommended in the UK for routine use. The U.S. guidance excludes this regimen from use in children or persons with radiographic evidence of prior tuberculosis (old fibrotic lesions) (69% effective). * 6 to 9H2 — An intermittent twice-weekly regimen for the above 2 treatment regimens is an alternative if administered under Directly observed therapy (DOT). * 4R — rifampicin for 4-months is an alternative for those who are unable to take isoniazid or who have had known exposure to isoniazid-resistant TB. * 3HR — Isoniazid and rifampin may be given daily for three months. * 2RZ — The two-month regimen of rifampin and pyrazinamide is no longer recommended for treatment of<unk> I because of the greatly increased risk of drug-induced hepatitis and death. * 3HP – three-month (12-dose) regimen of weekly rifapentine and isoniazid. The 3HP regimen has to be administered under DOT. A self-administered therapy (SAT) of 3HP is investigated in a large international study. Evidence for treatment effectiveness A 2000 Cochrane review containing 11 double-blinded, randomized control trials and 73,375 patients examined six and 12 month courses of isoniazid (INH) for treatment of<unk> . HIV positive and patients currently or previously treated for tuberculosis were excluded. The main result was a relative risk (RR) of 0.40 (95% confidence interval (CI) 0.31 to 0.52) for development of active tuberculosis over two years or longer for patients treated with INH, with no significant difference between treatment courses of six or 12 months (RR 0.44, 95% CI 0.27 to 0.73 for six months, and 0.38, 95% CI 0.28 to 0.50 for 12 months). A Cochrane systematic review published in 2013 evaluated four different alternatives regimens to INH monotherapy for preventing active TB in HIV-negative people with<unk>  infection. The evidence from this review found no difference between shorter regimens of Rifampicin or weekly, directly observed Rifapentine plus INH compare to INH monotherapy in preventing active TB in HIV-negative people at risk of developing it . However the review found that the shorter Rifampicin regimen for four months and weekly directly observed Rifapentine plus INH for three months “may have additional advantages of higher treatment completion and improved safety." However the overall quality of evidence was low to moderate (as per GRADE criteria )and none of the included trials were conducted in LMIC nations with high TB transmission and hence might not be applicable to nations with high TB transmission. Treatment efficacy There is no guaranteed "cure" for<unk> . "People infected with TB bacteria have a lifetime risk of falling ill with TB..." with those who have compromised immune systems, those with diabetes and those who use tobacco at greater risk. A person who has taken the complete course of Isoniazid (or other full course prescription for tuberculosis) on a regular, timely schedule may have been cured. "Current standard therapy is isoniazid (INH) which reduce the risk of active TB by as much as 90 per cent (in patients with positive<unk> I test results and fibrotic pulmonary lesions compatible with tuberculosis) if taken daily for 9 months." Emphasis added However, if a person has not completed the medication exactly as prescribed, the "cure" is less likely, and the "cure" rate is directly proportional to following the prescribed treatment specifically as recommended. Furthermore, "If you don't take the medicine correctly and you become sick with TB a second time, the TB may be harder to treat if it has become drug resistant." If a patient were to be cured in the strictest definition of the word, it would mean that every single bacterium in the system is removed or dead, and that person cannot get tuberculosis (unless re-infected). However, there is no test to assure that every single bacterium has been killed in a patient's system. As such, a person diagnosed with<unk>  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." This means that in areas where TB is endemic treatment may be even less certain to "cure" TB, as reinfection could trigger activation of<unk>  TB already present even in cases where treatment was followed completely.
Latent tuberculosis
Primary inoculation tuberculosis
Extensively drug-resistant tuberculosis
Totally drug-resistant tuberculosis
Tuberculosis in relation to HIV
Multidrug-resistant tuberculosis
Tuberculosis
Vietnamese tuberculosis