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The kind of TB you’ve probably heard about is the one that sounds like late night coughs, scorching fever, and night sweats. While many testimonials consist of people sharing their experience combating active Tuberculosis, there is an entirely different set of around 1.8 billion people who share the same disease, but in a different form. Latent and active TB both involve the bacteria Mtb, but the condition and activity of it are where the two separate. Having latent TB means that the bacterium is dormant, or basically asleep, in your body, where the germs are inactive and thus virtually harmless1. The bacterium is not reproducing or actively growing, and resultantly does not cause any symptoms of active TB. Most of the time, your body is able to identify the bacterium as an outside danger and successfully isolate it: many people never discover they have TB, because latent TB does not disturb our normal bodily functions; it coexists quietly—until it is triggered by various factors2. Around 10% of people with latent TB develop active TB, which demonstrates the importance of getting tested before it’s too late!
Typically, latent TB infections do not appear on X-rays and other examinations. The most common way to get checked for TB is through a TB blood test (Interferon Gamma Release Assays) and a TB skin test (TST)3. However, these systems are limited by outdated technology, low sensitivity, and poor specificity. Many problems have occurred because of the lack of differentiation between active and latent TB within these tests, not to mention the number of incorrect diagnoses made leading to improper treatment and the development of drug-resistance within the individual, which could prove detrimental if their latent TB reactivates in the future4. Additionally, the spontaneous and erratic nature of the disease means that there is little to no way of foreseeing the onslaught of active TB, making it even harder to predict and treat.
Active TB can be activated anywhere and anytime—situationally when your immune system is weakened or stressed by other burdens, leading to your body not being able to defend and maintain the structures preventing Mtb’s growth. From there, treatment consists of a slew of antibiotics, lasting from weeks to months on end. Often these antibiotics are taken in combination in order to mitigate the possibilities of the bacteria’s ability to develop drug resistance. If these regimens are stopped prematurely, this can lead to a mutated TB bacteria that is resistant to all the antibiotics taken, or immune to any medication taken, leaving no defense against treating the infected patient. There is still hope, however, as new research and innovations are being made to diagnose TB sooner and more precisely, such as GeneXpert MTB and other new technologies.
References
“What Is the Difference between Latent TB Infection and Active TB Disease? - Minnesota Dept. Of Health.”
“Latent Tuberculosis Can Turn Active at Any Time.” Www.uclahealth.org
Latent TB Infection Testing and Treatment: Summary of U.S. Recommendations Eliminating Tuberculosis (TB) in the United States Requires Expanding Testing and Treatment of Latent TB Infection.
Mukherjee, Srestha, et al. “Evolution of Tuberculosis Diagnostics: From Molecular Strategies to Nanodiagnostics.” Tuberculosis, vol. 140, 1 May 2023, pp. 102340–102340
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