Scoping review of post‐TB pulmonary vascular disease: Proceedings from the 2nd International Post‐Tuberculosis Symposium

Abstract

AbstractTuberculosis (TB) may cause significant long‐term cardiorespiratory complications, of which pulmonary vascular disease is most under‐recognized. TB is rarely listed as a cause of pulmonary hypertension (PH) in most PH guidelines, yet PH may develop at various stages in the time course of TB, from active infection through to the post‐TB period. Predisposing risk factors for the development of PH are likely multifactorial, involving active TB disease and post‐TB lung disease (PTLD), host‐related and environment‐related factors. Moreover, post‐TB PH should likely be classified in Group 3 PH, with the pathogenesis similarly complex and multifactorial as other Group 3 PH causes. Identifying risk factors that predispose to post‐TB PH may aid in developing risk stratification criteria for early identification and referral for confirmatory diagnostic tests. Given that universal screening for PH in TB survivors may be impractical and unfeasible, a targeted screening approach for high‐risk individuals would be sensible. In this scoping review of post‐TB PH, resulting from the proceedings of the 2nd International Post‐Tuberculosis Symposium, we aim to describe the epidemiology, risk factors, and pathophysiology of post‐TB PH. We emphasize diagnosing PH with an alternative set of diagnostic guidelines in resource‐constrained settings where right heart catheterization may not be feasible. Research to describe the burden and distribution of post‐TB PH should be prioritized as there is a current gap in knowledge regarding the prevalence and incidence of post‐TB PH among persons with TB.