The authors reply: In most instances, the availability of short, safe treatment regimens for patients with latent tuberculosis infection shifts the balance in favor of treatment, given the potential benefits in public health1 and individual health. Even if the patient in the vignette in our article had been infected as a young child, he would have had a predicted cumulative risk of active tuberculosis up to the age of 80 years of approximately 4 to 15%.2,3 Risk factors for tuberculosis include a mix of exposure (e.g., incarceration) and biology (e.g., chronic kidney disease). The former increases the likelihood of becoming infected, whereas the latter increases the risk of progression to active tuberculosis disease. The severity of most host biologic factors, including diabetes and chronic kidney disease, appears to play a role in the risk of progression as a continuum,4,5 highlighting the need for both a patient-centered, shared decision-making approach to the initiation of treatment for latent tuberculosis infection and a periodic reassessment of treatment benefits as compared with risks as shorter, safer treatment regimens become available.