Clinical Review EducationJAMA I US Preventive Services Task Force RECOMMENDATION STATEMENTScreening for Latent Tuberculosis Infection in AdultsUS Preventive Services Task Force Recommendation StatementUS Preventive Services Task ForceEditorial page1457IMPORTANCE In the US,tuberculosis remains an important preventable disease,includingactive tuberculosis,which may be infectious,and latent tuberculosis infection (LTBI).Multimediawhich is asymptomatic and not infectious but can later progress to active disease.Related article page1495andThe precise prevalence rate of LTBl in the US is difficult to determine;however,estimatedJAMA Patient Page page 1526prevalence is about 5.0%,or up to 13 million persons.Incidence of tuberculosis varies bySupplemental contentgeography and living accommodations,suggesting anassociation with social determinants⊕Related article atof health.jamanetworkopen.comOBJECTIVE To update its 2016 recommendation,the US Preventive Services Task Force(USPSTF)commissioned a systematic review on LTBI screening and treatment inasymptomaticadults seen in primary care,as well as the accuracy of LTBI screening testsPOPULATION Asymptomatic adults18 years or older at increased risk for tuberculosis.EVIDENCE ASSESSMENT The USPSTF concludes with moderate certainty that there is aAuthor/Group Information:Themoderate net benefit in preventing active tuberculosis disease by screening for LTBl inUSPreventive Services Task Forcepersons at increased risk for tuberculosis infection.(USPSTF)members are listed at theend of this article.RECOMMENDATION The USPSTF recommends screening for LTBI in populations at increasedCorresponding Author:Carol M.risk.(B recommendation)Mangione MD,MSPH,David GeffenSchool of Medicine,University ofCalifomia,Los Angeles,109404MA.2023329(7):l487-1494.db10.10015ama2023.4899Wilshire Blvd,Ste 700,Los Angeles.CA 90024 (chair@uspstf.net).Summary of RecommendationPopulationRecommendationGradeAsymptomatic adults atThe USPSTF recommends screening for LTBI in populations atincreased risk of latentincreased risk.tuberculosis infection(LTBI)See the Assessment of Risk section for additional informationon adults at increased risk.USPSTF indicatesUS PreventiveServices Task Force.See the Summary of Recommendation figure.Pathway to BenefitToachieve the benefitofscreening.it is important that personswho screen positive for LTBI receive follow-up and treatment.It bases its recommendations on the evidence of both the ben-Preambleefits and harms of the service and an assessment of the balance.The USPSTF does not consider the costs of providing a service inThe US Preventive Services Task Force (USPSTF)makes recommen-this assessment.dations about the effectiveness of specific preventive care servicesThe USPSTF recognizes that clinical decisions involve more con-for patients without obvious related signs or symptoms to improvesiderations than evidence alone.Cinicians should understand thethe health of people nationwide.evidence but individualize
