Post tuberculosis lung disease and tuberculosis sequelae: A narrative review

Area of Science:

• Pulmonology
• Infectious Diseases
• Public Health

Background:

• Post-tuberculosis lung disease (PTLD) and its sequelae represent a significant, yet underrecognized, global health challenge.
• Factors such as social determinants, immunocompromise, and inadequate tuberculosis (TB) treatment exacerbate PTLD.
• Historically, PTLD has been poorly defined, with heterogeneous studies hindering a clear understanding.

Purpose of the Study:

• To define and characterize the multifaceted nature of post-tuberculosis lung disease.
• To elucidate the pathophysiological, functional, and clinical consequences of PTLD.
• To highlight the impact of PTLD on quality of life and mortality.

Main Methods:

• Review of existing literature on PTLD and post-TB sequelae.
• Analysis of pathophysiological changes in airways, parenchyma, and pleura post-TB.
• Evaluation of functional impairments, including airflow limitation and respiratory failure.
• Assessment of quality of life, disease relapse, and mortality associated with PTLD.

Main Results:

• Successfully treated pulmonary TB can lead to persistent sequelae, including airway abnormalities, fibrocavitation, emphysema, and pleural fibrosis.
• Patients often experience airflow limitation, restrictive disease, or mixed patterns, potentially leading to respiratory or ventilatory failure.
• PTLD significantly impairs quality of life, increases susceptibility to infections, and is linked to progressive lung function decline, cardiovascular disease, cancer, and premature mortality.

Conclusions:

• PTLD is a complex and severe condition with profound long-term health consequences.
• The recognition and definition of PTLD are critical for improving patient outcomes and public health strategies.
• Further research is essential to better describe and address the premature mortality associated with PTLD.