Post-tuberculosis lung disease: new approaches in prevention and treatment

In collaboration with international partners as part of the International Post-Tuberculosis Symposium, the Institute of Infectious Diseases and Tropical Medicine at LMU University Hospital has published a comprehensive review of post-tuberculosis lung disease (PTLD) in The Lancet Respiratory Medicine. The article, co-authored by Dr. Andrea Rachow from the Tropical Institute, examines the long-term consequences of tuberculosis and emphasizes the urgent need for improved prevention, diagnosis and care strategies.

“In contrast to active tuberculosis, PTLD is no longer infectious,” explains Rachow. “Nevertheless, it often leads to significant health and social burdens.” Tuberculosis can leave scars in lung tissue and permanently damage the respiratory tract, impairing lung function and increasing the risk of chronic respiratory problems.

Studies show that up to 50 percent of survivors of pulmonary tuberculosis (PTB) experience impaired lung function – with 10 to 15 percent having severe impairments. Although there is a growing number of studies on the frequency and clinical patterns of lung damage and resulting functional impairments among tuberculosis survivors, and on the impacts to their everyday lives and ability to work, considerable knowledge gaps remain. The mechanisms of disease development, preventive measures, effective screening and diagnostic procedures as well as the costs, feasibility and impact of treatment strategies are particularly underexplored.

To better understand PTLD and optimize care, there is a need for further longitudinal observational studies that document in detail the progression of the disease along with the associated risk factors and long-term sequelae. The need for intervention studies is especially urgent, so that targeted measures for prevention and care can be developed for the first time. To do this, however, it is vital to consider the prevailing circumstances in local health systems, especially in the Global South, in order to create practical and sustainable solutions that are accessible to all patients.

Jamilah Meghji et al.: Post-Tuberculosis Lung Disease: Towards Prevention, Diagnosis, and Care. The Lancet Respiratory Medicine 2025