What is the appropriate management for a patient diagnosed with latent TB infection (LTBI) in terms of treatment options and follow-up?

Management of latent TB infection (LTBI) involves offering drug treatments only if hepatotoxicity is not a concern, particularly in adults aged 35 to 65 years ¹.

For adults, testing for HIV, hepatitis B, and C should be offered before starting treatment for LTBI ¹.

The recommended treatment options include:

• 3 months of isoniazid (with pyridoxine) and rifampicin, typically given to people younger than 35 at low risk of hepatotoxicity ¹.
• 6 months of isoniazid (with pyridoxine), especially when rifamycin drug interactions may be a concern (e.g., in people with HIV or transplant recipients) ¹.

Patients should be linked to support services, and social needs and adherence barriers should be assessed ¹.

Follow-up includes monitoring for adverse effects, particularly hepatotoxicity, and ensuring treatment completion. Patients should be advised of the risks and symptoms of TB and the importance of completing treatment ¹.

In cases of treatment interruption, re-establishing treatment should be done cautiously, with investigation of causes and sequential reintroduction of drugs ¹.

Post-treatment, routine follow-up is not recommended, but patients should be informed to watch for symptoms of relapse and contact the TB service promptly if symptoms develop ¹.