To the Editor: The recent article by Denholm brings timely attention to the importance of screening for latent tuberculosis infection (LTBI) in at-risk populations.1 Currently, screening for LTBI is targeted to patients who are thought to be at highest risk of reactivation, including patients infected with HIV and those receiving immunomodulator therapies. Given that the greatest risk factor for active TB in Australia is immigration from a region where TB is endemic, it seems reasonable to screen immigrants from endemic areas.
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- 1. Denholm JT. Immigration screening for latent tuberculosis infection. Med J Aust 2013; 198: 524.
- 2. Marks GB, Bai J, Simpson SE, et. al. Incidence of tuberculosis among a cohort of tuberculinpositive refugees in Australia. Reappraising the estimates of risk. Am J Respir Crit Care Med 2000; 162: 1851-1854.
- 3. Diel R, Loddenkemper R, Nienhaus A. Predictive value of interferon-gamma release assays and tuberculin skin testing for predicting progression from latent TB infection to disease state: a metaanalysis. Chest 2012; 142: 63-75.
- 4. LoBue PA, Moser KS. Use of isoniazid for latent tuberculosis infection in a public health clinic. Am J Respir Crit Care Med 2003; 168: 443.
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