Latent Mycobacterium tuberculosis Infection in Liver Transplant Recipients-Controversies in Current Diagnosis and Management

Srinivas Rajagopala; A Olithselvan; Joy Varghese; Naresh Shanmugam; Mohamed Rela

doi:10.1016/S0973-6883(11)60120-5

Latent Mycobacterium tuberculosis Infection in Liver Transplant Recipients-Controversies in Current Diagnosis and Management

J Clin Exp Hepatol. 2011 Jun;1(1):34-7. doi: 10.1016/S0973-6883(11)60120-5. Epub 2011 Aug 26.

Authors

Srinivas Rajagopala¹, A Olithselvan¹, Joy Varghese¹, Naresh Shanmugam¹, Mohamed Rela¹

Affiliation

¹ Institute of Liver Disease and Transplantation, Global Hospitals, Chennai, India.

Abstract

Liver transplantation for end-stage liver disease is increasingly being undertaken in India.(1) Routine tuberculin skin testing (TST) for latent Mycobacterium tuberculosis infection (LTBI) and isoniazid prophylaxis in TST-positive liver-transplant recipients (LTRs) is recommended(2,3) but seldom implemented worldwide.(4-7) The role of TST-testing and isoniazid prophylaxis in LTRs remains further undefined in high prevalence areas, including India. We describe the burden of LTBI in LTRs; the epidemiological aspects of M. tuberculosis infection in high prevalence areas; identifiable risk factors for M. tuberculosis infection; the limitations of current diagnostic techniques for LTBI in LTRs and the efficacy and toxicity of isoniazid prophylaxis in TST-positive LTRs and suggest directions for future investigations in this area.

Keywords: ATT, anti-tuberculosis medications; HCWs, healthcare workers; IGRA, IFN-γ release assays; Isoniazid prophylaxis; LT-TB, liver transplantation tuberculosis; LTBI, latent Mycobacterium tuberculosis infection; LTRs, liver-transplant recipients; SOT, solid-organ transplant; TST, tuberculin skin testing; latent tuberculosis infection; liver transplantation; solid organ transplantation; tuberculosis.