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Is treatment for tuberculosis necessary if Mantoux test is positive?

Q: I am a 31 years old female who tested positive for tuberculosis (TB) eight years ago through Mantoux test. Then, I had a chest X-ray done, which came negative. Recently, I was asked to undergo a test for TB and the doctor suggested treatment for nine months. I lived in Peru when I was a child and got the BCG vaccination at 10 or 12 years but have no records of that here. I want to get pregnant and have had a miscarriage in the past. I just had a chest X-ray done and it came negative for TB. I don't really want this treatment if is not really necessary. Is it necessary to undergo treatment for tuberculosis? Does contraceptive pill really work? Can it be taken while on treatment for TB?

A:Mantoux test detects previous exposure to tuberculosis. A positive Mantoux test cannot be used to diagnose active tuberculosis. Anti-tuberculous therapy is generally indicated to treat active tuberculosis. Active tuberculosis is said to be present when the affected person has signs and symptoms compatible with an active disease (this will depend on the site of the body affected). It appears from the description provided by you that you do not have active disease. Latent tuberculosis - where the person previously exposed to tuberculosis may harbour some bacteria in a dormant state is generally not an indication for anti-tuberculous therapy unless the person is at significant risk of disease reactivation due to underlying conditions (defects in immunity due to disease or medication). For occupational reasons screening for active TB is indicated, however treatment is generally recommended only for those with active disease. Some anti-tuberculous medications may interfere with contraceptive pills due to drug interactions however, if chosen carefully they do not generally interfere with pregnancy. It is better that you get a second opinion from a specialist experienced in the management of tuberculosis.

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