The prevalence and pattern of post tuberculosis lung disease including pulmonary hypertension from an Australian TB service; a single-centre, retrospective cohort study.

Abstract

Introduction: Post Tuberculosis Lung Disease (PTLD) is increasingly recognised as a significant cause of morbidity internationally, but has not been described in an Australian setting. We aimed to determine the prevalence of PTLD among adult TB survivors from an Australian TB service and describe the pattens of lung function abnormalities and pulmonary disease, including pulmonary hypertension.

Methods: We conducted a single-centre retrospective cohort study in Sydney, Australia, including all adults who successfully completed TB treatment between January 2013 and December 2022. Baseline characteristics, post treatment pulmonary function, and thoracic computed tomography (CT) data were analysed to determine the prevalence and patterns of PTLD, defined as any lung function and/or radiological abnormality attributable to TB.

Results: Among 119 confirmed TB patients (mean age 46 ± 21 years, 61% males) PTLD was identified in 81/119 (68%). Pulmonary function testing was available for 51/119 (43%), of whom 38/51(75%) exhibited abnormalities. Obstructive deficits were found in 25/51 (49%), restrictive deficits in 11/51 (22%), and impaired gas transfer capacity in 26/51 (51%). Chest CT scans were completed in 76/119 (64%), with 70/76 (92%) demonstrating significant abnormalities, including pulmonary fibrosis 43/76 (57%), bronchiectasis 22/76 (29%), and emphysema 11/76 (15%). Pulmonary hypertension was suspected in 52/76 (68%) patients based on radiological findings.

Conclusion: Despite successful treatment, PTLD was frequently observed among our cohort of Australian TB survivors. Further research into optimal screening practices to diagnose chronic pulmonary diseases and pulmonary hypertension could provide opportunities for earlier intervention and management.