Chronic airway obstruction after successful treatment of tuberculosis and its impact on quality of life

SETTING: Tuberculosis (TB) clinic in Tijuana, Mexico. BACKGROUND: Chronic airway obstruction (GAO) can be a sequella of pulmonary tuberculosis (PTB), independently of smoking history. OBJECTIVE: To determine the prevalence of CAO in subjects recently recorded as cured after treatment of PTB, and its impact on quality of life. DESIGN: Cross-sectional study. RESULTS: Overall, 34.3% of patients with a history of PTB had non-reversible GAO, defined as FEV1 <70% post-bronchodilator. Subjects with GAO had significantly more radiographic fibrocavitary sequellae on chest X-rays, more extensive changes (1.8 +/- 0.8 affected quadrants vs. 1.3 +/- 0.6, P = 0.04), more residual lung cavities (1.4 +/- 0.8 vs. 0.5 +/- 0.7, P= 0.002), and greater mediastinal retraction (42.4% vs. 16.7%, P = 0.026). The mean COPD Assessment Test score for subjects with GAO was 15.1 +/- 10.4. The prevalence of irreversible GAO using the lower limit of normal criteria was higher (40%) than that calculated with fixed ratio criteria (34.3%). CONCLUSION: Functional abnormalities are frequently already present at the end of treatment for PTB; patients with GAO are often symptomatic and experience a significant impact on quality of life.