Reaffirming its earlier recommendation, the US Preventive Services Task Force (USPSTF) has stated that all asymptomatic adults at increased risk for TB should be screened for latent tuberculosis (TB) infection. The final recommendation statement was published May 2, 2023 in JAMA.¹ It further says that those who test positive for latent TB should be followed-up and given treatment.

A grade B recommendation has been issued, which means that “The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial”. Based on this, it suggests that clinicians should offer or provide this service. ²

The statement has identified the persons at high risk of exposure. They include persons who were born in, or had earlier lived in, countries with high prevalence of TB and persons residing in or have been residents of high-risk congregate settings such as homeless shelters or correctional facilities. The screening may be a one-time screening or may be done annually for those who are continually exposed to the risk of infection. The statement mentions Tuberculin Skin Test (TST) and Interferon-Gamma Release Assay (IGRA) as the screening tests.

As per the CDC, persons with latent TB infection are asymptomatic and cannot transmit the infection to others. The tuberculosis skin test is usually positive. But if left untreated, they can develop active TB disease.³

References

1. US Preventive Services Task Force; Mangione CM, et al. Screening for latent tuberculosis infection in adults: US Preventive Services Task Force recommendation statement. JAMA. 2023 May 2;329(17):1487-1494. doi: 10.1001/jama.2023.4899.
2. Grade definitions. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/methods-and-processes/grade-definitions. Accessed on May 3, 2023.
3. TB terms. Centers for Disease Control and Prevention. https://www.cdc.gov/tb/topic/basics/glossary.htm. Accessed May 3, 2023.