Post-Tuberculosis Lung Disease in Treated Extra-Pulmonary Tuberculosis

Background Post-tuberculosis lung disease is a well-recognized sequela of pulmonary tuberculosis (PTB). Extra-pulmonary tuberculosis (EPTB) accounts for a quarter of the global tuberculosis burden; yet pulmonary sequelae in people treated for EPTB are unknown. Methods We performed spirometry at successful treatment completion, and semi-annually thereafter for 1.5 years, among adults (≥18 years) with drug-sensitive PTB and EPTB recruited from outpatient clinics in India. Adult household contacts without current tuberculosis disease underwent spirometry at enrolment and served as non-tuberculosis controls. Logistic and linear regression was used to measure the association of treated EPTB with ventilatory defects and persistence of impaired lung function during post-treatment follow-up, respectively. Results We enrolled 775 tuberculosis survivors, 275 (35%) of whom were treated for EPTB, and 502 non-tuberculosis controls. Compared to controls, EPTB was associated with lower z-scores for FEV1 (-0.37, 95%CI -0.54 to -0.20, p Conclusion People treated for EPTB have persistent ventilatory defects and respiratory symptoms and should be screened for post-tuberculosis lung disease.