Adolescent pulmonary tuberculosis (TB) survivors have poorer lung function and greater disability than their uninfected peers for up to two years after treatment completion, concludes a study led by Brown University researchers.
For the study, published today in Pediatrics, the research team used lung-function tests and the St. George’s Respiratory Questionnaire (SGRQ) to twice evaluate the lung health of 101 formerly infected participants aged 10 to 19 years in Lima, Peru, who were successfully treated for TB. They compared the results with those of 101 matched uninfected controls.
TB survivors with abnormal lung function underwent chest computed tomography (CT) from March 2022 to September 2023, and the investigators modeled changes in lung function and disability for two years post-treatment.
Dedicated post-TB lung disease studies among adolescents are important because their bodies differ from those of adults. “Even if adolescents have adult-type TB, puberty-related immune changes may modify their risk and clinical phenotype of post-TB lung disease, which likely stems from inflammatory response to Mycobacterium tuberculosis,” the authors wrote. “Moreover, adolescent lungs grow in gas exchange surface area and airway size until, approximately, the age of 20 years.”
Need for post-treatment assessment
Compared with controls, TB survivors had less favorable forced expiratory volume in 1 second, forced vital capacity, total airway resistance (R5), small airway resistance (R5-20), and reactance area (AX).
Over the study period, AX, R5, and R5-20 improved for survivors but were still worse than those of controls. Survivors also had persistently greater respiratory disability. The chest CTs of TB survivors revealed architectural distortion (86.1%), reticular (mesh-like) patterns (80.6%), nodules (55.6%), and bronchiectasis (irreversible widening, scarring, and inflammation of the bronchial tubes; 47.2%).
“Adolescent TB survivors experience persistent, symptomatic chronic lung disease despite bacteriological cure,” the authors wrote. “Our findings highlight the need for respiratory assessments beyond treatment completion.”