Obstructive lung disease in patients with treated pulmonary tuberculosis

Abstract

Little is known of functional sequelae of tuberculosis. The aim of the study was to evaluate the association between chronic obstructive pulmonary disease (COPD) and pulmonary tuberculosis.

Methods: In consecutive 224 patients treated for pulmonary tuberculosis (between the ages of 20 and 82 years) who were observed at a local dispensary pulmonary function tests were performed.

Results: Pulmonary impairment was present in 105 (46,9%) patients including 81 (36,2%) patients with airflow obstruction (FEV1/FVC <0.7) and 24 (10,7%) patients with restrictive pattern (FEV1/FVC ≥0.7 and FVC or FEV1<80% predicted). Of 224 patients, GOLD criteria classified 10,3% of subjects as having mild COPD, 19,2% subjects as having moderate COPD, and 6,7% as having severe COPD. The prevalence of stage II or higher COPD in patients aged 40 and older and in younger patients was 31% and 5%, respectively (p<0,001). In patients with culture-positive pulmonary tuberculosis in the past the prevalence of stage II or higher COPD was 32% and in patients with culture-negative pulmonary tuberculosis the prevalence of stage II or higher COPD was 17% (p<0,05). In patients who had two or more episodes of tuberculosis the prevalence of stage II or higher COPD was 47% and in patients with one episode the prevalence of stage II or higher COPD was 23% (p<0,01).). We did not find influence of gender, smoking on the prevalence of stage II or higher COPD.

Conclusions: A microbiological cure is not the end of illness. Tuberculosis is associated with frequent airflow obstruction. Culture-positive pulmonary tuberculosis in the past, episodes of tuberculosis may increase the prevalence of stage II or higher COPD.