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Q: I am 28 years old and recently had a tuberculin skin test done to determine whether I have been in contact with tuberculosis. I never had this test done before and my chest X- ray is normal. Do I need any treatment?
A: A tuberculin skin test is very important to determine whether an individual has previously been exposed to tuberculosis and now runs the risk of acquiring the active form of the disease. In fact, if no treatment is initiated, about 5% of persons whose skin tuberculin test converts from negative to positive will have the disease activated within two years, while an additional 5% of these tuberculin test converters will develop the disease sometime during their lifetime. However, by treating these individuals with appropriate antibiotics the risk of acquiring tuberculosis is considerably reduced. The standard prevention treatment consists of administering the patient 300 mg. INH for about 6-12 months and 50 mg. of vitamin B6. The vitamin B6 is added to prevent some of the deleterious effects on the nerves which may be caused by INH. This treatment should be given to people who have newly converted from a negative to a positive tuberculin test within the last two years; persons with a positive test who are less than 35 years of age, independent of how long their test has been positive; persons who give a history of untreated tuberculosis or who have chest radiographic evidence of disease; persons who have a positive tuberculin test and who are at high risk of acquiring the disease, such as patients with HIV infection, diabetes, end-stage kidney disease, etc.; close contacts of patients with active tuberculosis who have a positive tuberculin test; and close contacts of individuals with active tuberculosis who are at high risk for acquiring tuberculosis, regardless of whether or not they have a positive tuberculin test. Hence, in your particular case, since you are only 28 years of age and have a positive tuberculin test with a normal chest x-ray, the standard recommendation is that you need treatment with INH and vitamin B6, as described above, in order to prevent the activation of tuberculosis.
Updated: 06/12/99
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