Tuberculosis (TB) screening and treatment (Tuberculosis screening and treatment (latent and active))
Tests to find tuberculosis infection (sleeping or active) and the medicine course used to treat it, which must be completed in full to work and to prevent drug resistance.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- TB comes in two forms: latent (sleeping, no symptoms, not infectious) and active (causes symptoms and lung TB can be infectious).
- Screening uses a blood test or skin test for latent TB, and a chest X-ray plus sputum tests for active TB.
- Treatment is a combination of antibiotics over months — you must finish the whole course, or the bacteria can become drug-resistant.
- TB testing and treatment are free on the NHS for everyone; active TB is a notifiable infection, so close contacts are offered screening.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Finds infection early, before latent TB can develop into active disease
Private screening is not a substitute for urgent NHS assessment if you have symptoms of active TB such as coughing up blood or significant weight loss.
A skin test is read at 48–72 hours; blood test results come within days. A chest X-ray and sputum results guide whether active TB is present.
A named TB nurse or team and clear contact details
A skin test is read at 48–72 hours; blood test results come within days. A chest X-ray and sputum results guide...
Symptoms of active TB often improve and, for infectious lung TB, you usually become non-infectious after a few...
You keep taking the full combination of medicines and attend monitoring appointments and blood tests, even though...
Standard active TB treatment lasts about six months; latent TB treatment about three to six months. Your team...
What is TB screening and treatment?
Tuberculosis (TB) is a bacterial infection that usually affects the lungs but can affect other parts of the body. It spreads through the air when someone with active lung TB coughs. TB is treatable and curable with the right course of medicines.
There are two forms. Latent TB means the bacteria are in your body but sleeping — you have no symptoms and cannot pass it on, but it can 'wake up' into active TB later, especially if your immune system weakens. Active TB causes symptoms such as a persistent cough, fever, night sweats and weight loss, and lung TB can be infectious.
Screening finds infection. Latent TB is detected with a blood test (an IGRA) or a skin test (Mantoux). Active TB is investigated with a chest X-ray and samples of phlegm (sputum) sent for testing.
Treatment uses a combination of antibiotics taken for months. It is vital to finish the whole course, even once you feel well, because stopping early can let the bacteria survive and become resistant to the medicines, which is much harder to treat.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Latent vs active TB
| Latent TB | Active TB | |
|---|---|---|
| Symptoms | None | Cough, fever, night sweats, weight loss |
| Infectious? | No | Lung TB can be |
| Main treatment | 3–6 months | Usually 6 months |
Latent TB is not illness, but treating it lowers the chance of it becoming active disease later. Your TB team will advise.
Preparing for your treatment
- If you have symptoms such as a cough lasting more than three weeks, fever, night sweats or weight loss, tell your GP or TB service promptly.
- Bring details of where you have lived or travelled, especially countries where TB is common.
- Mention any known contact with someone who has had TB.
- List your medicines and any conditions or treatments that weaken your immune system, including HIV.
- Tell the team if you could be pregnant, as this affects some medicines and the use of X-rays.
- Bring any previous TB test results or BCG vaccination history.
- For a skin test, you will need to return in 2–3 days to have it read.
What happens
For latent TB, you usually have a blood test (IGRA) or a skin test (Mantoux). The skin test involves a small injection into the forearm, read by a nurse 48 to 72 hours later. A positive result means TB infection, not necessarily active disease.
If active TB is suspected, you have a chest X-ray and provide sputum samples, which are examined under a microscope and cultured to confirm TB and check which medicines will work. Other tests are done if TB is suspected elsewhere in the body.
If TB is diagnosed, a specialist TB team explains your treatment, how long it lasts and how to take it. Because active TB is a notifiable infection, it is reported to public health, and your close contacts are offered screening. Some people are supported to take their medicines under supervision to help them complete the course.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Private screening is not a substitute for urgent NHS assessment if you have symptoms of active TB such as coughing up blood or significant weight loss.
- A skin or blood test alone cannot diagnose active TB — that needs a chest X-ray and sputum tests.
- Self-treatment or buying TB medicines without specialist supervision is unsafe and risks resistance.
- Stopping treatment early because you feel better is not an option, as it risks resistant disease.
Delay or rearrange if…
- If active TB is suspected, do not delay — it needs prompt investigation and treatment.
- Pregnancy affects the choice of some medicines and the use of X-rays, so this needs discussing first.
- Significant liver problems or other medicines may need review before starting treatment.
- An unclear screening result may need repeating before decisions are made.
Alternatives to discuss
- Monitoring without preventive treatment for some people with latent TB, after weighing the risks
- Different drug combinations if standard medicines are not tolerated
- Specialist (multidrug-resistant TB) regimens where resistance is found
- NHS TB service referral rather than private testing, given NHS TB care is free
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Finds infection early, before latent TB can develop into active disease
- Confirms active TB and which medicines will work, so the right treatment starts
- Treatment usually cures TB completely when the full course is taken
- Protects other people by identifying and treating infectious TB
- Allows close contacts to be screened and treated if needed
Risks & complications
- Discomfort from a blood test or skin test, and a local reaction where the skin test is given
- Side effects from TB medicines, such as nausea or harmless orange discolouration of urine and tears with rifampicin
- Needing regular monitoring blood tests during treatment
- An unclear test result that needs repeating or further assessment
- Liver irritation from the medicines, which is why liver tests are monitored
- Interactions with other medicines, including reduced effectiveness of some, such as hormonal contraception with rifampicin
- A serious reaction to a TB medicine, needing it to be changed
- Drug-resistant TB, which needs longer and more complex treatment
- Severe active TB affecting the lungs or other organs if diagnosis or treatment is delayed
The most important point is completing the full course. Stopping early, or taking medicines irregularly, can let the bacteria survive and become drug-resistant, which is far harder and longer to treat. If side effects are troubling you, tell your TB team rather than stopping on your own. Monitoring blood tests during treatment are there to catch problems such as liver irritation early.
Published figures to discuss
Standard, drug-sensitive TB is usually curable when treatment is completed, and most people tolerate the medicines with monitoring. The main risks are liver irritation from the medicines and, if treatment is interrupted, the development of drug resistance. Because outcomes depend heavily on completing treatment, the type of TB and individual factors, fixed percentages are not given here; your TB team can explain your situation.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Cure of drug-sensitive active TB | Usually high when the full course is completed | Standard treatment takes months and needs adherence support; stopping early risks relapse and resistance. | NHS — Tuberculosis (TB)nhs.ukSource-linked context |
| Liver irritation from TB medicines | Recognised treatment risk | Isoniazid, rifampicin and pyrazinamide can affect the liver; jaundice, dark urine or severe nausea need urgent advice. | NHS — Tuberculosis (TB)nhs.ukSource-linked context |
| Drug-resistant TB | Higher after previous TB treatment, exposure to resistant TB or poor adherence | Culture and susceptibility testing guide treatment length and drug choice. | Guide sourcesClinical context |
| Infectiousness to close contacts | Depends on site and smear/culture status | Pulmonary TB may require isolation advice, public-health notification and contact tracing. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
For screening there is nothing to recover from. For active TB, you usually start to feel better within weeks of starting treatment, but the course continues for months to make sure the infection is fully cleared.
- Feeling better within weeks of starting active TB treatment, well before the course ends
- Orange-coloured urine, tears or sweat while taking rifampicin (harmless)
- Some tiredness or mild stomach upset from the medicines
- Needing regular reviews and blood tests during the months of treatment
Aftercare
- Take every dose of your TB medicines exactly as prescribed and finish the entire course, even when you feel well.
- Do not stop or skip medicines without speaking to your TB team, as this risks drug resistance.
- Attend all monitoring appointments and blood tests during treatment.
- Report side effects such as yellowing of the skin or eyes, persistent sickness, rash or vision changes promptly.
- If you are on rifampicin, ask about effects on other medicines, including contraception.
- Help with contact tracing if asked, so people close to you can be checked.
- Tell your team if you find it hard to keep taking the medicines, so they can support you.
- Full understanding of which medicines to take and for how long
- A schedule or reminder system for daily medicines
- Dates for monitoring blood tests and reviews
- List of side effects that need urgent attention
- Details of your TB nurse or team to contact
- Information for close contacts about being screened
⚠ Get urgent help if…
- Yellowing of the skin or eyes, dark urine or persistent vomiting (possible liver problem) — contact your team urgently
- Coughing up blood
- A new rash, fever or severe reaction after starting medicines
- Changes in vision or colour vision (a possible effect of one TB medicine)
- Breathlessness or worsening chest symptoms
- Feeling unable to keep taking the medicines, so you are at risk of stopping
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A negative screening test usually means no TB infection was found, though tests can occasionally be unclear and need repeating. A positive latent TB test means infection is present but not active disease, and your team will discuss whether preventive treatment is right for you.
For active TB, successful treatment clears the infection and is usually curative when the full course is completed. Becoming non-infectious early in treatment protects those around you, but it does not mean treatment is finished — the remaining months matter to prevent relapse and resistance.
Completing treatment usually cures TB, but it does not make you immune — reinfection is possible with new exposure. Latent TB that has been treated is much less likely to reactivate. If you ever develop symptoms again, or your immune system becomes weakened, you should be reassessed.
Related tests, treatments or support
TB care is coordinated by a specialist TB team and is closely linked to public health: active TB is notifiable, and contact tracing means people close to you are offered screening. People with TB are also usually offered an HIV test, because the two affect each other, and any test is done with your consent.
Follow-up & long-term care
You are followed up regularly throughout treatment to check the medicines are working, monitor for side effects, and support you to complete the course. Your team confirms when treatment is finished. Close contacts identified through contact tracing are followed up separately by the TB service.
- Take the full course of medicines to completion, exactly as prescribed.
- Attend monitoring blood tests and reviews throughout treatment.
- Seek reassessment if symptoms return or your immune system becomes weakened.
- Support close contacts in attending their own screening.
Repeat, follow-on and what comes next
- Medicines may be adjusted if side effects occur or monitoring blood tests show liver irritation.
- Treatment is extended for TB in certain sites, such as the brain, or where progress is slow.
- Drug-resistant TB requires a different, longer regimen under specialist care.
- An unclear screening test may need repeating or further assessment.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A named TB nurse or team and clear contact details
- A schedule of monitoring appointments and blood tests throughout treatment
- Support to complete the course, including supervised treatment where helpful
- Clear handling of contact tracing, notification and an HIV test offer with consent
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether you are seen through the NHS (where TB care is free) or a private service
- Which screening tests are used (blood test, skin test, chest X-ray, sputum tests)
- Whether latent or active TB is found, as treatment differs in length
- The medicines used and the monitoring blood tests needed over months
- Whether the TB is drug-resistant, requiring longer and more complex treatment
- Any specialist or hospital input if you are very unwell or highly infectious
- Confirmation that NHS TB care is free, before considering any private route
- Which screening tests are included and how results are given
- What treatment and monitoring are covered if TB is found
- How long treatment is expected to last and the review schedule
- What happens if the TB is drug-resistant and needs specialist care
- How contact tracing and public health notification are handled
On the NHS? TB testing and treatment are free on the NHS for everyone in the UK, regardless of immigration status, because treating TB protects both the individual and the public.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not understanding that the full course must be completed to avoid resistance
- Believing a single test can diagnose or rule out active TB on its own
- Not being told about monitoring blood tests or important interactions, such as rifampicin and contraception
- Not being clear that active TB is notifiable and contacts will be offered screening
Marketing red flags
- Private services implying paid testing is necessary when NHS TB care is free
- Offering TB medicines without proper diagnosis, monitoring or specialist oversight
- Suggesting a quick test can fully rule out active TB
- Not explaining the importance of completing treatment or the public health duties involved
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Do I have latent or active TB, and what does that mean for me?
- Which medicines will I take, for how long, and what are the side effects?
- How will you monitor me during treatment, and what blood tests will I need?
- What should I do if I get side effects or find it hard to keep taking the medicines?
- Will my contacts need to be screened, and how does that work?
- Could my TB be drug-resistant, and how would that change treatment?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is TB treatment free in the UK?
What is the difference between latent and active TB?
Why do I have to take the medicines for so long?
What happens if I stop treatment early?
Will my family and friends be tested?
Do I need to stay off work or away from others?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Tuberculosis (TB) NICE NG33 — Tuberculosis: recommendations GOV.UK (UKHSA) — Tuberculosis (TB): migrant health guide GOV.UK — Notifying suspected or confirmed active tuberculosis (TB) GOV.UK (UKHSA) — Tuberculosis: diagnosis, screening, management and data
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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