Patients over 35 years experience more side-effects during latent TB treatment: Experience from an urban hospital with a high incidence of Tuberculosis

Abstract

Introduction: Tuberculosis (TB) remains one of the world's deadliest communicable diseases. In 2013, 1.5 million people died from TB infection and a further 9.0 million became infected with the disease. 10–15% of individuals with latent TB infection (LTBI) will develop active TB.

Aims: Queen Elizabeth (QEH) is a hospital in Greenwich, London, serving a population of 500,000. In 2012, the incidence of TB in Greenwich was 40-69/100,000. We sought to analyse LTBI management in our high incidence population.

Method: Retrospective analysis of medical records of patients treated for LTBI between Jan 2011 and Dec 2014.

Results: 260 patients with an average age of 26.5 years (range 1-78) were treated for LTBI (table 1), of which 51.5% (n=134) were male. 60.4% (n=157) patients were referred for LTBI screening through contact tracing and a significant proportion of patients, 21.5%, were referred via occupational health departments. All patients completed LTBI treatment and tolerated well in 252/260 (97%) of patients. Patients over 35 years experienced a 5-fold increase in treatment side-effects (10% vs. 1.8%)

Conclusions: LTBI treatment is well tolerated and completion rates are excellent. Treatment side-effects were greatest in patients over 35 years highlighting this at-risk group.

References: Collaborative Tuberculosis Strategy for England 2014 to 2019 PHE.