TB Origins – Dr Jack Callum on TB Infection and the Timing of Immunosuppression Commencement

Dr Alice Sawka, adult respiratory and TB physician in Adelaide, is joined by Dr Jack Callum, respiratory physician in London, and Dr Victoria Grey, infectious diseases physician in Brisbane, to explore the evidence behind delaying TNF-alpha inhibitor therapy after starting TB preventive treatment. Together, they discuss the risk of TB reactivation with biologic therapies, the origins of current guideline recommendations, and how clinicians balance urgent immunosuppression with TB prevention in everyday practice. This episode is the first in the TB Origins series, exploring the evidence and history behind long-standing TB clinical practices.