潛伏結核感染診斷與治療簡介

Abstract

結核病由結核分枝桿菌引起，透過空氣傳播，全球仍是重大公共衛生挑戰。根據WHO數據，2022年全球結核病例約有1,060萬，130萬人死亡。台灣2023年報告6630確診個案及457死亡案例。潛伏結核感染(latent tuberculosis infection, LTBI)指結核菌在體內休眠，不致病也不具傳染性，但可能轉為活動性結核病。診斷依賴皮膚測試或血液檢測，治療目的是防止未來發展為活動性病例。針對高風險族群進行LTBI治療是全球消除結核病目標的重要策略之一，如接觸者、HIV感染者、以及具發病高風險之潛在疾病者等。治療方式包括多種藥物處方，並需監測副作用。台灣政策已導入相關策略，以期達成2035年消除結核的目標。  Tuberculosis (TB) is a disease caused by infection with Mycobacterium tuberculosis. Transmitted through the air, TB remains one of the great challenges in global public health and infectious disease control. Latent TB infection (LTBI) refers to a state where TB bacteria survive in the body but remain dormant and inactive, not causing clinical symptoms such as cough, fever, weight loss, or night sweats; thus, LTBI is not contagious. However, untreated LTBI can later develop into active tuberculosis. The bacteria will begin to proliferate and cause disease-related symptoms. TB-related abnormalities may be detected through imaging checks such as X-rays even without obvious clinical symptoms. The World Health Organization estimates that about one-quarter of the global population has LTBI. Although most individuals with LTBI do not develop active TB in their lifetime, those with weakened immune systems, such as patients with HIV, diabetes, or on immunosuppressive drugs, and older adults with age-related immune decline, face a significantly increased risk of LTBI progressing to active TB. This article introduces the latest global and Taiwanese strategies and advancements in diagnosing and treating LTBI, aiming to enhance health-care workers’ understanding of LTBI treatment, thereby contributing to Taiwan’s goal of eliminating TB by 2035.