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Even among low\u2010TB burden countries that have achieved high rates of detection and successful treatment for active TB, a number of barriers have prevented implementing or expanding LTBI treatment programmes. Of those infected with TB, relatively few will develop active disease and the current diagnostic tests have a low predictive value. LTBI treatment using isoniazid (INH) has low completion rates due to the long duration of therapy and poor tolerability. Both patients and physicians often perceive the risk of toxicity to be greater than the risk of reactivation TB. As a result, LTBI treatment has had a limited or negligible role outside of countries with high resources and low burden of disease. New tools have emerged including the interferon\u2010gamma release assays that more accurately diagnose LTBI, particularly in people vaccinated with Bacillus Calmette\u2013Guerin (BCG). Shorter, better tolerated treatment using rifamycins are proving safe and effective alternatives to INH. While still imperfect, TB prevention using these new diagnostic and treatment tools appear cost effective in modelling studies in the United States and have the potential to improve TB prevention efforts globally. Continued research to understand the host\u2013organism interactions within the spectrum of LTBI is needed to develop better tools. Until then, overcoming the barriers and optimizing our current tools is essential for progressing toward TB elimination.<\/jats:p>","DOI":"10.1111\/resp.13346","type":"journal-article","created":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T07:37:33Z","timestamp":1528961853000},"page":"893-900","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":97,"title":["Latent tuberculosis infection: Opportunities and challenges"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8660-5710","authenticated-orcid":false,"given":"Cynthia B.E.","family":"Chee","sequence":"first","affiliation":[{"name":"TB Control Unit, Department of Respiratory and Critical Care Medicine Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Reves","sequence":"additional","affiliation":[{"name":"Denver Health and Hospital Authority  Denver Public Health Department CO USA"},{"name":"University of Colorado, Division of Infectious Diseases, Health Sciences Center  Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Molecular Microbiology and Immunology Bloomberg School of Public Health, Johns Hopkins University  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7382-8592","authenticated-orcid":false,"given":"Robert","family":"Belknap","sequence":"additional","affiliation":[{"name":"Denver Health and Hospital Authority  Denver Public Health Department CO USA"},{"name":"University of Colorado, Division of Infectious Diseases, Health Sciences Center  Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.2744"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1005750"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a121593"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0017601"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/137.4.805"},{"key":"e_1_2_7_7_1","first-page":"605","article-title":"Tuberculosis among patients with various radiologic abnormalities, followed by the chest clinic service","volume":"104","author":"Grzybowski S","year":"1971","journal-title":"Am. 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