Assessing risk and managing Mycobacterium tuberculosis infection and disease in patients due to start anti-TNFalpha treatment.

This short paper describes the rationale being applied in the United Kingdom to the problem of treating latent TB infection in persons requiring anti-TNF-alpha treatment. This will largely have to be done by an individual risk/benefit analysis based on the risks of developing disease from national epidemiology compared with the risks of significant hepatotoxicity from treatment of latent infection.