title: Optimizing the management of children with latent tuberculosis infection.
abstract: The management of latent tuberculosis (LTBI) in children represents an important issue for paediatricians because of the disease burden, the lack of a gold standard for the diagnosis and the high annual risk of progression to active disease. Areas covered: A review of English language articles on LTBI in children, published between the 1st of January 2010 and the 1st of July 2016, was conducted using multiple keywords and standardized terminology in PubMed database. This review provides an updated overview of the available tests for LTBI diagnosis in children, management strategies and treatment options. Expert commentary: Two tests are available for LTBI diagnosis: tuberculin skin test and interferon-gamma release assays, both with a suboptimal specificity and sensitivity, and both with the lack of capability in distinguishing between infection and disease. Several new markers have been identified but further studies are needed. Among all treatment regimes, because of the high safety and efficacy profile showed and to avoid the poor completion rate, the treatment with a three-month course of isoniazid and rifampicin is currently recommended. New vaccines are needed because of the spread of the disease despite BCG vaccination in high risk countries. Currently, 15 new vaccines are in the pipeline.
authors.affiliation: a Department of Health Sciences , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: E
authors.initials: E
authors.lastname: Venturini
authors.affiliation: a Department of Health Sciences , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: C
authors.initials: C
authors.lastname: Tersigni
authors.affiliation: a Department of Health Sciences , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: E
authors.initials: E
authors.lastname: Chiappini
authors.affiliation: a Department of Health Sciences , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: M
authors.initials: M
authors.lastname: de Martino
authors.affiliation: a Department of Health Sciences , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: L
authors.initials: L
authors.lastname: Galli
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D054357:Chemokine CXCL10 / Q000097:blood*; D002648:Child; D019468:Disease Management; D004797:Enzyme-Linked Immunosorbent Assay; D058501:Enzyme-Linked Immunospot Assay; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D007538:Isoniazid / Q000627:therapeutic use; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000254:growth & development / Q000276:immunology; D012293:Rifampin / Q000627:therapeutic use; D014374:Tuberculin Test; D032581:Tuberculosis Vaccines / Q000008:administration & dosage / Q000096:biosynthesis; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control
chemical_list: D000995:Antitubercular Agents; D015415:Biomarkers; C114753:CXCL10 protein, human; D054357:Chemokine CXCL10; D032581:Tuberculosis Vaccines; D007371:Interferon-gamma; D007538:Isoniazid; D012293:Rifampin
keywords: Latent tuberculosis; children; diagnosis; management; treatment