LTBI screening indication

Increased risk of Mtb infection

Increased risk of reactivation

Congregate setting workers/residents

Recent close contacts of untreated TB cases

Recent immigrants from TB endemic areas

Serial screening: TST or IGRA

LTBI treatment, after excluding active TB

Initial screening: Two-step TST or IGRA

Initial test negative

Initial test positive

End

High probability of false-negative result

Repeat testing 8-10 wk after last exposure

Repeat TST or IGRA positive

Repeat TST or IGRA negative

^*IGRA preferred for individuals with prior bacillus Calmette-Guérin and individuals at high risk for becoming lost to follow-up. TST preferred for children younger than 5 yr. Dual testing (not shown) may be considered for certain situations.

TST or IGRA^*

TST or IGRA positive

TST or IGRA negative

TST or IGRA^*

TST or IGRA negative

TST or IGRA positive