title: Latent Mycobacterium tuberculosis Infection in Liver Transplant Recipients-Controversies in Current Diagnosis and Management.
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.
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals, Chennai, India.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Rajagopala
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals, Chennai, India.
authors.forename: A
authors.initials: A
authors.lastname: Olithselvan
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals, Chennai, India.
authors.forename: Joy
authors.initials: J
authors.lastname: Varghese
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals, Chennai, India.
authors.forename: Naresh
authors.initials: N
authors.lastname: Shanmugam
authors.affiliation: Institute of Liver Disease and Transplantation, Global Hospitals, Chennai, India.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Rela
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