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Latent TB Infection and TB Disease

Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and TB disease.

Latent TB Infection

TB bacteria can live in the body without making you sick. This is called latent TB infection. In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. People with latent TB infection:

  • Have no symptoms
  • Don’t feel sick
  • Can’t spread TB bacteria to others
  • Usually have a positive TB skin test reaction or positive TB blood test
  • May develop TB disease if they do not receive treatment for latent TB infection

Many people who have latent TB infection never develop TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have a weak immune system, the bacteria become active, multiply, and cause TB disease.

TB Disease

TB bacteria become active if the immune system can’t stop them from growing. When TB bacteria are active (multiplying in your body), this is called TB disease. People with TB disease are sick. They may also be able to spread the bacteria to people they spend time with every day.

Many people who have latent TB infection never develop TB disease. Some people develop TB disease soon after becoming infected (within weeks) before their immune system can fight the TB bacteria. Other people may get sick years later when their immune system becomes weak for another reason.

For people whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is much higher than for people with normal immune systems.
The Difference between Latent TB Infection (LTBI) and TB Disease

A Person with Latent TB Infection A Person with TB Disease
  • Has no symptoms
  • Has symptoms that may include
    • a bad cough that lasts 3 weeks or longer
    • pain in the chest
    • coughing up blood or sputum
    • weakness or fatigue
    • weight loss
    • no appetite
    • chills
    • fever
    • sweating at night
  • Does not feel sick
  • Usually feels sick
  • Cannot spread TB bacteria to others
  • May spread TB bacteria to others
  • Usually has a skin test or blood test result indicating TB infection
  • Usually has a skin test or blood test result indicating TB infection
  • Has a normal chest x-ray and a negative sputum smear
  • May have an abnormal chest x-ray, or positive sputum smear or culture
  • Needs treatment for latent TB infection to prevent TB disease
  • Needs treatment to treat TB disease
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