Latent tuberculosis infection (LTBI) affects one-fourth of the world´s population. Hematopoietic stem cell transplantation (HSCT) recipients are at an elevated risk of developing active tuberculosis infection (ATBI). In this retrospective study of donors and HSCT recipients who underwent transplantation between February 2000 and June 2018, our aim was to determine the prevalence of LTBI and ATBI and to describe diagnostic and therapeutic strategies in an HSCT population in an endemic region. The cohort of 409 participants included 125 allogeneic HSCT (allo-HSCT) recipients, 165 autologous HSCT (auto-HSCT) recipients, and 119 HSCT donors. Patients were evaluated pre-HSCT with tuberculin skin test and thoracic imaging. LTBI was diagnosed in 26.2% of the cohort. Cases represented 20% of the auto-HSCT population, 20% of the allo-HSCT population, and 41.2% of the donor population. Pre-HSCT evaluation to rule out ATBI was performed in 62.6% of the cohort; all results were negative. Isoniazid was administered to 73.3% of those with LTBI. Within subgroups, 91.7% of HSCT recipients and 51% of donors received treatment. The median duration of therapy pre-HSCT was 70 days in recipients and 48 days in donors. The incidence of post-HSCT ATBI was 0 at 1-year follow-up. The incidence of LTBI in our population was higher than expected and still might have been underestimated owing to diagnostic test limitations. The absence of incident ATBI suggests that recipients, as opposed to donors, must receive LTBI treatment. Prevention of infectious complications in the HSCT population should be prioritized to improve clinical outcomes. Prospective data from collaborative working groups is needed to determine the best diagnostic and therapeutic approaches in this vulnerable patient population.

潜伏性结核感染（LTBI）影响世界四分之一的人口。造血干细胞移植（HSCT）接受者发生活动性肺部感染（ATBI）的风险较高。在这项对2000年2月至2018年6月间接受移植的供体和HSCT接受者的回顾性研究中，我们的目标是确定LTBI和ATBI的患病率，并描述流行地区HSCT人群的诊断和治疗策略。409名参与者的队列包括125位同种异体HSCT（allo-HSCT）接受者，165位自体HSCT（auto-HSCT）接受者和119位HSCT供体。在HSCT之前对患者进行了结核菌素皮肤测试和胸部影像学评估。LTBI被诊断为队列的26.2％。病例占自动HSCT人口的20％，同种HSCT人口的20％，和捐助者人口的41.2％。在HSCT前评估中排除ATBI的人群占62.6％；所有结果均为阴性。LTBI的患者中，异烟肼的使用率为73.3％。在亚组中，有91.7％的HSCT接受者和51％的捐助者接受了治疗。接受HSCT治疗的中位时间在接受者中为70天，在捐献者中为48天。在1年的随访中，HSCT后ATBI的发生率为0。在我们的人群中，LTBI的发生率高于预期，由于诊断测试的局限性，其可能仍被低估了。ATBI事件的缺乏表明，与捐赠者不同，接受者必须接受LTBI治疗。应优先预防HSCT人群的感染性并发症，以改善临床结果。