Pathophysiology
Clinical meaning
TB management: LTBI treatment prevents progression to active TB (5-10% lifetime risk). LTBI regimens: 3HP (isoniazid + rifapentine weekly x12 weeks, preferred), 4R (rifampin daily x4 months), 9H (isoniazid daily x9 months). Active TB: RIPE therapy (Rifampin, Isoniazid, Pyrazinamide, Ethambutol) x2 months intensive, then RI x4 months continuation. DOT (directly observed therapy) is standard of care. Isoniazid: supplement with pyridoxine (B6) 25-50mg to prevent peripheral neuropathy. Monitor LFTs monthly. Sputum AFB cultures at 2 months for conversion.