Post-Tuberculosis Sequelae Take a Toll on Life Expectancy

TOPLINE:

The life expectancy of patients diagnosed with tuberculosis (TB) was found to be reduced compared with that of individuals without TB. Post-TB sequelae also reduced life expectancy and quality-adjusted life expectancy among TB survivors in the United States. 

METHODOLOGY:

• Researchers aimed to estimate the health impact of TB, including post-TB sequelae, among survivors in terms of life expectancy compared with that among people without any reported incidences of TB.
• They used nationally representative data of 45,738 individuals diagnosed with TB (mean age, 48 years; 61% men) in the United States from 2015 to 2019.
• A mathematical model was constructed to estimate life expectancy and quality-adjusted life-years (QALYs) for the TB cohort compared with those for the no-TB cohort.

TAKEAWAY:

• The mean life expectancy after diagnosis was 30.3 years for individuals with TB vs 32.3 years for matched individuals without TB, representing a reduction of 2.03 years (95% uncertainty interval, 1.84-2.21) and 1.93 QALYs (95% uncertainty interval, 1.69-2.18).
• The greatest reductions in life-years were observed in individuals in the age group of 65-74 years (3.04 years), men (2.15 years), and American Indian or Alaska Native individuals (2.83 years).
• Post-TB sequelae accounted for 41% of life-years lost (95% uncertainty interval, 35-46) and 48% of QALYs lost (95% uncertainty interval, 42-54).

IN PRACTICE:

“Although the United States has been successful at interrupting TB transmission and reducing incidence, TB still represents a major health event for those developing the disease,” the authors wrote.

“Alongside interventions that prevent TB occurring in the first place, efforts to achieve prompt diagnosis and treatment, to support successful treatment completion, and to provide comprehensive medical follow-up for individuals with post-TB sequelae are important for limiting the lifetime health losses caused by TB,” they added.

SOURCE:

This study was led by Nicolas A. Menzies, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston. It was published online on February 10, 2025, in the American Journal of Respiratory and Critical Care Medicine.

LIMITATIONS:

The imputation of missing data may have led to an underestimation of total TB-related health losses, particularly for individuals who refused treatment or were lost to follow-up. Deaths occurred due to other causes that could not be attributed to TB. Additionally, the study period excluded recent TB data, potentially limiting the generalizability of the data.

DISCLOSURES:

This study was funded by the Centers for Disease Control and Prevention and National Center for HIV, Viral Hepatitis, STD, and TB Prevention Epidemiologic and Economic Modeling Agreement. The authors reported no conflicts of interest. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.