Management of Tuberculosis

To the Editor: When discussing indications for the treatment of latent tuberculosis infection, Small and Fujiwara (July 19 issue) 1 follow the joint statement of the American Thoracic Society and the Centers for Disease Control and Prevention (CDC) 2 in considering patients regardless of age. Prior guidelines did not recommend routine treatment for those older than 35 years, the point at which isoniazid hepatotoxicity was thought to be more likely to occur than disease reactivation. 3 Is age no longer a concern? For example, since treatment is now recommended for all tuberculin-positive persons who have emigrated from high-prevalence areas to the United States . . .