The Lengthy Tuberculosis Treatment Regimen It’s very common for people with tuberculosis to relapse during treatment. Treatment for tuberculosis symptoms can last anywhere from six months to a year, and sometimes more for drug-resistant tuberculosis. There are multiple pills that need to be taken every single day – at the same time each day, without fail – or the treatment might not work. You may start to feel better and think that your tuberculosis has been successfully treated, only to find out that it’s back – stronger and more difficult to treat. Or you may have done everything right and the disease is gone, only to find that you are infected with tuberculosis again. How Tuberculosis Reinfection Happens There is much debate over whether recurrent tuberculosis is caused by a relapse — getting sick again with the same strain of tuberculosis even after treatment — or tuberculosis reinfection with a new strain of the bacteria. In the United States and Canada, it seems that most recurrent tuberculosis cases are a relapse of the original infection, perhaps because of insufficient treatment, and not because of tuberculosis reinfection with a new strain of bacteria. The situation is different in other parts of the world. In a study done in Cape Town, South Africa, where tuberculosis is very common, 18 percent of the 612 study participants had tuberculosis reinfection. Fourteen percent of those patients had been successfully treated for their illness and were infected again with a different strain of TB. Many people may have what’s called latent tuberculosis infection, meaning that they have no tuberculosis symptoms, but the bacteria are still in their body. Once the bacteria become active and cause tuberculosis symptoms, the infection becomes active TB. Who Gets Reinfected? Based on the Cape Town study results, researchers did not find any risk factors that made people who had been reinfected with tuberculosis more likely to get sick again. People who have had tuberculosis before and get it again are at a much higher risk of developing tuberculosis disease than someone who has never had the illness. More research needs to be done, but scientists suspect that some people may be more susceptible to tuberculosis than others for reasons that are not yet known. Another study conducted on HIV-positive people infected with tuberculosis suggests that HIV makes them more susceptible to tuberculosis reinfection than non-HIV positive patients are. Tuberculosis Reinfection Treatment Treating recurrent tuberculosis that is caused by relapse — treatment that wasn’t successful or was incomplete — is difficult. Often the bacteria have become resistant to treatment and a different combination of drugs, taken over a longer period of time, is often the recommended course of treatment. One study showed that a main cause of drug-resistant tuberculosis, the kind that’s most difficult to treat, is reinfection. Even when tuberculosis reinfection occurs from a different strain of bacteria, the recurrent type is often drug-resistant, meaning that some kind of a mutation of the original strain of bacteria doesn’t respond to drugs. If the recurrent case responds to the drugs, then it can be successfully treated. Again, the regimen must be followed to the letter. Preventing Tuberculosis Reinfection You can’t always prevent tuberculosis, be it a primary or recurrent infection. But you can take steps to reduce your risk. For those with HIV, one way of trying to prevent tuberculosis reinfection is to use the antibiotic isoniazid (INH). Once treatment for tuberculosis is completed, a course of preventive antibiotics might be an option to reduce the risk of tuberculosis reinfection in HIV-positive people. The best way to prevent tuberculosis from striking again is to always take medications exactly as recommended by your doctor. And as obvious as it sounds, limiting exposure to people who may be contaminated with tuberculosis also reduces the risk of reinfection.
