Impact of tuberculosis on median survival time and years of potential life lost in patients: A scoping review.

OBJECTIVE: Tuberculosis significantly affects human health and longevity. We aimed to systematically synthesize studies to summarize the median survival time range and years of potential life lost (YPLL) among tuberculosis patients.

METHODS: We searched Web of Science, PubMed, China National Knowledge Infrastructure, and Wanfang Data from inception to October 1, 2024. Studies reporting median survival time or YPLL in patients with drug-susceptible or drug-resistant tuberculosis were included, mostly involving adult participants. Two reviewers independently screened studies and extracted data. Any disagreements were resolved by consensus or by arbitration from a third reviewer.

RESULTS: A total of 22 studies were incorporated into this analysis. Patients with multidrug resistant tuberculosis (MDR -TB) had a median survival of 1.9-7.6 years (indexed from diagnosis), compared with 2.9-6.5 years for extensively drug-resistant tuberculosis (XDR-TB) and 2.0-8.0 years for Non- MDR -TB. Notably, untreated MDR -TB patients presented with particularly unfavorable survival outcomes. Patients coinfected with HIV and tuberculosis (TB/HIV) consistently showed very short survival times, whereas individuals with pneumoconiosis but without tuberculosis had substantially longer survival compared to those with both conditions. Life expectancy estimates revealed that TB/HIV coinfection reduced life expectancy at age 30 to between 4.2 and 21.6 years, in stark contrast to over 35.0 years in individuals with HIV but without tuberculosis. Years of potential life lost analyses indicated that patients with active tuberculosis lost 4.9-15.8 years of potential life, compared to 1.3 years for those with latent tuberculosis infection (LTBI). TB/HIV coinfection further amplified this burden, with losses reaching up to 16.3 years. Using a fixed age cut-off of 69 years, patients with tuberculosis lost an average of 39.1 years of potential life compared with 24.5 years among non-TB controls.

CONCLUSION: Most studies suggest that tuberculosis shortens survival and increases potential years of life lost, particularly in patients with drug-resistant tuberculosis, TB/HIV coinfection, or untreated tuberculosis, although there is important variation by patient group and study method. Early diagnosis and appropriate treatment may help reduce life loss and improve life expectancy.