© 2006 American Thoracic Society
The Scope and Impact of Treatment of Latent Tuberculosis Infection in the United States and CanadaFrom the Authors:We thank Dr. Moulding for his comments on our recent article (1). We agree that treatment of latent tuberculosis infection should be targeted to persons who are at highest risk of progressing to tuberculosis, namely, household contacts of persons with active disease, recent tuberculin skin-test converters, children, persons with old, healed disease, and immunocompromised persons. Dr. Moulding is also correct that the decline in risk of tuberculosis is substantially greater in the first 9 years after onset of Mycobacterium tuberculosis infection than in subsequent decades. The rates that we used for our estimates of the lifetime risk of tuberculosis after skin-test conversion estimated the average rate for the second decade as 90% of the rate in the final year of the first 9-year period, not 90% of the average rate during the first 9-year period (2). We regret that this may not have been completely clear in that article. However, the estimates of the potential benefit of treatment of latent tuberculosis infection that we calculated in our article in the AJRCCM (1) are consistent with the data cited by Dr. Moulding.
Boston University School of Public Health, Boston, Massachusetts
Vanderbilt University Medical Center, Nashville, Tennessee
Westsat, Rockville, Maryland
Centers for Disease Control and Prevention, Atlanta, Georgia
Denver Public Health and Hospitals Authority, Denver, Colorado FOOTNOTES Conflict of Interest Statement: None of the authors has a financial relationship with a commercial entity that has an interest in the subject of this manuscript. REFERENCES
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