Prevention of Tuberculosis Reactivation

In Canada, where the incidence of tuberculosis (TB) is low and the risk of exposure to TB is low, most cases of active TB are due to the reactivation of a latent TB infection (LTBI) rather than a new TB infection. Certain factors are associated with an increased risk of reactivation of active TB and include HIV infection, diabetes, renal failure, certain cancers, and treatment with immunosuppressants. There is a need for a better understanding of measures that can be taken to prevent TB reactivation. In July 2020, CADTH searched the literature for evidence on the prevention of TB reactivation. This previous CADTH report identified 1 network meta-analysis (NMA), 1 non-randomized study, and 2 guidelines, that met the inclusion criteria based on their titles and abstracts. The purpose of the current report is to review the full texts of these publications and to summarize and critically appraise the eligible publications. This report is a component of a larger CADTH condition-level review on TB. A condition-level review is an assessment that incorporates all aspects of a condition, from prevention and detection to treatment and management. For more information on CADTH’s condition-level review of TB, please visit the project page (https://www.cadth.ca/tuberculosis).