Charting the Course in Post-Tuberculosis Lung Disease: From Inflammation to Intervention.

Post-Tuberculosis Lung Disease (PTLD), a persistent sequelae of Tuberculosis (TB) in which TB survivors continue to experience respiratory symptoms and diminished lung function after microbiological cure, poses a significant and growing public health challenge. Its prevalence varies widely due to differences in treatment adequacy, comorbidities, and environmental exposures and afflicts particularly high TB-burden countries. Recent advances in fundamental science, clinical investigations and exploratory trials have expanded our understanding of PTLD pathogenesis and progression. Yet, critical questions remain unanswered: Which patients are most at risk? How can we intervene early to prevent or mitigate disability? And how should healthcare systems adapt to monitor, manage, and support the growing population of TB survivors? This review aims to inform ongoing efforts in clinical care, research, and policy. We summarize recent evidence on PTLD-specifically disease mechanisms, clinical manifestations, diagnostic approaches, risk factors, and treatment strategies. It also highlights key knowledge gaps and implementation challenges and proposes research priorities to steer future inquiry and practice. Greater research investment and stronger global collaboration are needed to mitigate the long-term burden of PTLD and improve outcomes for TB survivors.