The spectrum of latent tuberculosis: rethinking the biology and intervention strategies

Nat Rev Microbiol. 2009 Dec;7(12):845-55. doi: 10.1038/nrmicro2236. Epub 2009 Oct 26.


Immunological tests provide evidence of latent tuberculosis in one third of the global population, which corresponds to more than two billion individuals. Latent tuberculosis is defined by the absence of clinical symptoms but carries a risk of subsequent progression to clinical disease, particularly in the context of co-infection with HIV. In this Review we discuss the biology of latent tuberculosis as part of a broad range of responses that occur following infection with Mycobacterium tuberculosis, which result in the formation of physiologically distinct granulomatous lesions that provide microenvironments with differential ability to support or suppress the persistence of viable bacteria. We then show how this model can be used to develop a rational programme to discover effective drugs for the eradication of M. tuberculosis infection.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antigens, Bacterial / immunology
  • Antitubercular Agents / therapeutic use
  • Computational Biology
  • Drug Delivery Systems
  • Drug Design
  • Latent Tuberculosis / drug therapy
  • Mycobacterium tuberculosis / drug effects*
  • Mycobacterium tuberculosis / enzymology*
  • Reagent Kits, Diagnostic
  • Tuberculosis, Pulmonary / drug therapy


  • Antigens, Bacterial
  • Antitubercular Agents
  • Reagent Kits, Diagnostic