Post-TB lung disease is a term that encompasses diverse chronic lung disease and respiratory pathologies experienced by TB patients after treatment for TB disease.57,62,63 TB survivors have high rates of airway disease, including chronic obstructive pulmonary disease (COPD), bronchiectasis and airway stenosis57,62,63 and also experience higher rates of restrictive lung disease.63 Infectious pulmonary complications also occur at a higher rate, including chronic aspergillus lung disease and non-tuberculous mycobacterial disease.63
Post-TB lung disease is diverse in presentation and likely under-appreciated by clinicians. To date, there is a lack of prospective data to support evidence-based recommendations on appropriate screening and treatment interventions, but research is rapidly evolving in this area. All patients should be evaluated for respiratory disease during TB therapy, including a focused history and physical examination. Pulmonary function testing is recommended for all people completing therapy for pulmonary TB, given the high incidence of pulmonary function abnormalities in this population.62,64 In areas with limited access to a pulmonary function laboratory, spirometry can be performed as an acceptable first-line test.
We conditionally recommend that pulmonary function testing be performed on all people at the end of treatment for pulmonary TB, or within six months of completing treatment (poor evidence).
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