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Systemic immunosuppression is a risk factor for LTBI reactivation and the development of active tuberculosis. Such reactivation carries a risk of significant morbidity and mortality. Despite the increasing global incidence of inflammatory bowel disease (IBD) and the use of immune\u2010based therapies, current guidelines on the testing and treatment of LTBI in patients with IBD are haphazard with a paucity of evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To review the screening, diagnostic practices and medical management of LTBI in patients with IBD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Published literature was reviewed, and recommendations for testing and treatment were synthesised by experts in both infectious diseases and IBD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Screening for LTBI should be performed proactively and includes assessment of risk factors, an interferon\u2010gamma releasing assay or tuberculin skin test and chest X\u2010ray. LTBI treatment in patients with IBD is scenario\u2010dependent, related to geographical endemicity, travel and other factors. Ideally, LTBI therapy should be used prior to immune suppression but can be applied concurrently where urgent IBD medical treatment is required. Management is best directed by a multidisciplinary team involving gastroenterologists, infectious diseases specialists and pharmacists. Ongoing surveillance is recommended during therapy. Newer LTBI therapies show promise, but medication interactions need to be considered. There are major gaps in evidence, particularly with specific newer therapeutic approaches to IBD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Proactive screening for LTBI is essential in patients with IBD undergoing immune\u2010suppressing therapy and several therapeutic strategies are available. Reporting of real\u2010world experience is essential to refining current management recommendations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16952","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T03:55:12Z","timestamp":1653105312000},"page":"6-27","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Review article: latent tuberculosis in patients with inflammatory bowel diseases receiving immunosuppression\u2014risks, screening, diagnosis and management"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5344-2548","authenticated-orcid":false,"given":"Sasha R.","family":"Fehily","sequence":"first","affiliation":[{"name":"Gastroenterology Department St Vincent's Hospital  Melbourne Victoria Australia"},{"name":"Department of Medicine University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4735-5234","authenticated-orcid":false,"given":"Aysha H.","family":"Al\u2010Ani","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne  Parkville Victoria Australia"},{"name":"Gastroenterology Department Royal Melbourne Hospital  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7550-8202","authenticated-orcid":false,"given":"Jonathan","family":"Abdelmalak","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Rentch","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Royal Melbourne Hospital  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Zhang","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Royal Melbourne Hospital  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin T.","family":"Denholm","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne  Parkville Victoria Australia"},{"name":"Infectious Diseases Department Royal Melbourne Hospital  Parkville Victoria Australia"},{"name":"Victorian Tuberculosis Program  Melbourne Victoria Australia"},{"name":"Department of Infectious Diseases Doherty Institute  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne  Parkville Victoria Australia"},{"name":"Infectious Diseases Department Royal Melbourne Hospital  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6850-4454","authenticated-orcid":false,"given":"Siew C.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics Institute of Digestive Disease, The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2472-3409","authenticated-orcid":false,"given":"Vishal","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5647-1723","authenticated-orcid":false,"given":"David T.","family":"Rubin","sequence":"additional","affiliation":[{"name":"University of Chicago Medicine Inflammatory Bowel Disease Center University of Chicago Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Monash University and Alfred Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8746-4275","authenticated-orcid":false,"given":"Britt","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne  Parkville Victoria Australia"},{"name":"Gastroenterology Department Royal Melbourne Hospital  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,20]]},"reference":[{"key":"e_1_2_20_2_1","volume-title":"World health organisation. 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