Do you routinely treat pregnant patients for latent tuberculosis or delay treatment until 2-3 months post-partum?
Guidelines from CDC, WHO, ATS/IDSA recommend delaying the treatment of latent TB in pregnancy until 2-3 months postpartum unless there is a high risk of progression to TB disease e.g. HIV co-infection. This is because the risk of hepatotoxicity from isoniazid is higher during pregnancy and in the early postpartum period (2-3 months after delivery) and for most otherwise healthy HIV-negative pregnant individuals the risk of progression from latent TB to active TB in pregnancy is relatively low. Factors that increase the risk of progression include HIV co-infection or other significant immunosuppressive condition, a recent close contact with someone with active pulmonary TB, and recent conversion of tuberculin skin test of IGRA test for laten...
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