Airflow Obstruction in Post-tuberculosis Lung Disease: A 5-year Prospective Cohort Study

Area of Science:

• Pulmonology
• Infectious Diseases
• Radiology

Background:

• Post tuberculosis lung disease (PTLD) encompasses conditions like tuberculosis-associated chronic obstructive pulmonary disease (TB-COPD).
• The long-term clinical trajectory and risk factors for airflow obstruction in PTLD are not fully understood.

Purpose of the Study:

• To evaluate longitudinal changes in lung function over five years in patients treated for active pulmonary tuberculosis.
• To identify predictors of airflow obstruction in this cohort.

Main Methods:

• A cohort of patients with active pulmonary TB was followed longitudinally.
• Assessments included lung function tests and chest CT scans at treatment completion and five years post-treatment.

Main Results:

• Airflow obstruction increased from 13.2% at baseline to 17.0% at 5-year follow-up.
• Significant decline in mean FEV1/FVC ratio observed over five years.
• Chest CT findings in obstructed patients were consistent with TB-COPD, including air trapping, even in younger, non-smoking individuals.

Conclusions:

• Airflow obstruction is a significant long-term complication of pulmonary TB.
• The development and persistence of obstruction, particularly TB-COPD phenotype, highlight the need for extended follow-up.
• Routine lung function assessment is recommended for TB survivors.