# Screening for Latent Tuberculosis Infection in Adults

## Purpose of the protocol
To update the 2016 US Preventive Services Task Force (USPSTF) recommendation on screening for latent tuberculosis infection (LTBI) in adults.

## Target population
- if age >= 18 years (asymptomatic adults)
- if increased risk factors are present such as:
    - if born in or are former residents of countries with high tuberculosis prevalence
    - if live in or have lived in high-risk congregate settings (e.g., homeless shelters, correctional facilities)

## Recommendation
The USPSTF recommends screening for LTBI in populations at increased risk.

## Importance
- Prevalence: Approximately 5.0% or up to 13 million persons in the United States are estimated to have LTBI.
- Health Risks: About 30% of persons exposed to Mycobacterium tuberculosis will develop LTBI, and 5% to 10% of healthy, immunocompetent persons with LTBI will progress to active tuberculosis if left untreated.
- Disparities: Tuberculosis disproportionately affects certain populations in the US, including Asian, Black, Hispanic/Latino, Native American/Alaska Native, and Native Hawaiian/Pacific Islander persons.

## Conclusion
The USPSTF concludes with moderate certainty that there is a moderate net benefit in preventing active tuberculosis disease by screening for LTBI in persons at increased risk for tuberculosis infection. The harms of treatment are small, mainly hepatotoxicity, and there are no significant harms from screening.