I just applied for a job that required a TB test. It came back positive but I don’t have any symptoms. I have had rheumatoid arthritis but that doesn’t bother me with the new meds I’m on. The rheumatologist is saying I have a “latent” case of TB. What does that mean exactly?

You may be experiencing something that has been recently recognized as a potential problem. Patients with rheumatoid arthritis who are treated with some of the newer immune modifying drugs are experiencing a reactivation of latent (inactive or silent) tuberculosis. The same thing is happening to organ transplant recipients and patients with other immune-based problems who are being treated with these kinds of medications.

People with latent tuberculosis have the live tuberculosis bacteria in their bodies. But you aren’t contagious and can’t spread TB. With latent tuberculosis, there aren’t any symptoms of TB but treatment is needed to prevent the TB from becoming active (full-blown disease).

Studies show the latent form of TB becomes active in about 10 per cent of all cases. A reactivated case of TB can have some serious consequences. Treating latent tuberculosis can reduce the risk of active infection by 60 per cent. That statistic supports the recommendation to screen regularly and treat rheumatoid arthritis patients who test positive for latent tubercular disease.

It sounds like your job requirements including a TB test was a blessing in disguise. Getting treatment is the most likely next step. If your physician hasn’t already discussed treatment with you, ask what are her recommendations and go from there.