Before a biologic, most clinics order one interferon-gamma release assay or tuberculin skin test and file the result. In a high-burden setting, exposure continues after that test. Repeat the test at intervals during treatment, ask about new cough, fever, weight loss or household TB contacts at every visit, and document it. A patient whose spouse starts TB treatment needs retesting whatever the date of the last result.
- Ask about household TB contacts and symptoms at every biologic review.
- Repeat IGRA or tuberculin testing periodically in high-burden settings.
- Retest immediately after any known TB exposure.
Why it matters
Conversion after a negative baseline test is exactly the risk the one-off screen misses.
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