New approaches to the treatment of latent tuberculosis

It is estimated that one third of the global population is infected with Mycobacterium tuberculosis. Treatment of M tuberculosis infection is an important strategy for tuberculosis elimination, but the effectiveness of this strategy is limited by poor adherence to therapy, which is due at least in part to the long duration of treatment. A 9-month course of isoniazid is the currently preferred treatment regimen for M tuberculosis infection, due to the extensive data regarding the effectiveness and tolerability of isoniazid, and limited data on the effectiveness and tolerability of alternative shorter-course regimens. This review covers all currently available regimens, including less established alternative treatment regimens (e.g., rifampin for 4 months and isoniazid + rifampin for 3 months), as well as regimens that are currently under investigation (e.g., isoniazid + rifapentine for 3 months). Potential future regimens and experimental approaches are also discussed.