A Conversation Guide for Healthcare Providers 

Talking with Your Patients about 

Latent Tuberculosis (TB) Infection 

Tuberculosis (TB) remains an important preventable disease in the United States. It is estimated 

that up to 13 million people in the United States live with latent TB infection (sometimes also called 

inactive TB). Because latent TB infection can develop into active TB disease, patients can become 

very sick and may unknowingly spread TB to others, including friends, family, or healthcare workers. 

Testing and treating latent TB infection is a critical step to eliminating TB disease in the 

United States and protecting your community. As a trusted source of health information 

in your community, it’s important to initiate a conversation about latent TB infection and TB 

disease with your patients since there may be a lack of awareness about or stigma associated 

with these conditions. 

 Here are 4 tips to start the conversation: 

1 Introduce TB & Explain Latent TB Infection and TB Disease

It’s important to educate 

your patients about 

latent TB infection and 

TB disease since many 

people may not be 

familiar with or have 

certain misconceptions 

about these conditions. 

Here are some quick 

facts you can share: 

People with TB can be found in every state; where we 

work, where we live, where we learn, and where we spend 

time with family and friends. 

Latent TB infection is a condition in which a person is 

infected with the TB bacteria but does not currently have 

active TB disease. People with latent TB infection do not 

have signs and symptoms of TB disease and cannot spread 

TB bacteria to others. However, if these bacteria become 

active and multiply, latent TB infection can develop into 

TB disease. Once active, TB can be spread from person to 

person through the air. 

Latent TB infection can be treated to prevent TB disease. 

However, if left untreated, it can develop into active TB 

disease which can be fatal and can spread to others, 

including friends and family. 
2 Discuss Your Patient’s Risk

TB is a leading cause of 

deaths worldwide, and 

too many people still 

suffer from TB in the 

United States. There are 

several risk factors for TB 

so it’s important to talk 

with your patients about 

their risk. Here is some 

sample language that 

might help: 

Let's discuss your risk based on areas of the world 

where TB is common. TB is common throughout the 

world, but if you’re born in or frequently travel to Asia, 

Africa, or Latin America, you have a higher chance of 

getting infected with TB. This is true even if you’ve lived in 

the United States for a long time because it’s more 

common in these regions. You may be at risk for TB even 

if you have received the TB vaccine (also known as the 

BCG vaccine), because its protection weakens over time. 

Let’s discuss your exposure to individuals at higher risk. 

You may have a higher risk for TB if you work in, currently 

live in, or used to live in larger group settings where TB is 

more common, such as homeless shelters, prisons, or 

jails, or if you have spent time with someone who has 

active TB disease. 

Let’s consider other health conditions you may have. 

Health conditions, particularly those that may weaken 

your immune system such as diabetes, cancer, or HIV, 

may increase your chance for developing active TB 

disease if you have been infected. 

3 Explain the Testing Process

TB Blood 

Test 

TB Skin Test 

Patients may not be 

familiar with testing for 

latent TB infection, so it’s 

helpful to explain the 

process. Here are some 

messages that may help: 

There are two types of tests for latent TB infection: the 

TB blood test and the TB skin test. I prefer to order the 

blood test because it can be done in one visit, and it’s the 

most accurate if you’ve been vaccinated for TB in the past. 

After you get tested and receive your results, let’s talk 

about next steps. 

• If you receive a positive result, I will recommend other

tests including a physical examination, chest x-ray, and

other lab work to see if the TB bacteria is active or

making you sick.

• If you receive a negative result and we rule out active TB

disease, it is unlikely that you have latent TB infection and

no immediate next steps are needed. However, we will

talk about if you need to be tested again in the future.
4 Discuss Treatment Options

If your patient 

tests positive 

for latent 

TB infection, 

it's critical 

that you 

recommend 

shorter and more convenient 

treatments. While all the 

regimens are safe and 

effective, short course, 

rifamycin-based regimens 

are the preferred treatment 

options for latent TB infection 

because they have higher 

completion rates. 

People may not seek 

follow-up care due to 

misinformation or stigma 

associated with this disease 

so it's important to help them 

complete the full course of 

treatment. Consider the 

following information when 

discussing treatment options 

with your patients: 

Even though you do not have symptoms with latent 

TB infection, you can develop active TB disease, 

which can spread TB from person to person, can 

make you sick, and can even be fatal if left untreated. 

Completing your treatment is important to 

prevent active TB disease. You may have heard of 

someone going through a lengthy TB treatment in 

the past, but short and convenient treatments are 

now available. 

Let's discuss treatment options, any potential 

barriers that could disrupt your treatment plan, and 

community resources that can support you. Some 

common questions patients have about the 

available treatment options include: 

• What are the benefits of getting treated for

latent TB infection?

• Based on my lifestyle and personal health history,

what treatment option would you recommend?

• How often do I need to take this medication?

And how long will I be on it?

• What are the instructions for taking

this medication?

• What are the side effects of this medication?

• What is the cost of this medication? Will my

insurance cover treatment?

Without treatment, 1 in 10 people with latent TB infection will get 

sick in the future. You play a critical role in reducing the spread 

of TB in your community and the United States. 

To learn more about TB and how you can protect yourself and 

others, visit www.cdc.gov/thinktesttreattb 

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