Which patients should be screened for latent TB infection (LTBI) before initiating biologic agents for the treatment of rheumatoid arthritis (RA)?

Updated: Feb 07, 2020
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

In patients with RA who are under consideration for beginning or receiving treatment with biologic agents, screening for latent tuberculosis (TB) infection (LTBI) is recommended, regardless of whether these individuals have risk factors for LTBI. Nevertheless, clinicians should review patients’ medical histories to identify the following LTBI risk factors, as defined by the Centers for Disease Control and Prevention (CDC) [4] :

  • Close contacts of individuals known to have or suspected of having active TB

  • Foreign-born individuals from areas with a high incidence of active TB

  • Individuals with frequent or prolonged visits to areas with a high prevalence of active TB

  • Residents and employees of congregate settings whose clients are at increased risk for active TB

  • Healthcare workers serving clients who are at increased risk for active TB

  • Locally defined populations with an increased incidence of latent Mycobacterium tuberculosis infection or active TB

  • Infants, children, and adolescents exposed to adults who are at increased risk for latent M tuberculosis infection or active TB


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