Ning Jingxian, Wang Rong, Pan Yuchen, Fei Xinru, Jiang Wenxin, Martinez Leonardo, Zhu Limei, Qin Zhihua, Liu Qiao
Department of Chronic Communicable Disease, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
J Clin Tuberc Other Mycobact Dis. 2025 Oct 16;41:100568. doi: 10.1016/j.jctube.2025.100568. eCollection 2025 Dec.
Tuberculosis significantly affects human health and longevity. We aimed to systematically synthesize studies to summarize the median survival time range and years of potential life lost (YPLL) among tuberculosis patients.
We searched Web of Science, PubMed, China National Knowledge Infrastructure, and Wanfang Data from inception to October 1, 2024. Studies reporting median survival time or YPLL in patients with drug-susceptible or drug-resistant tuberculosis were included, mostly involving adult participants. Two reviewers independently screened studies and extracted data. Any disagreements were resolved by consensus or by arbitration from a third reviewer.
A total of 22 studies were incorporated into this analysis. Patients with multidrug resistant tuberculosis (MDR -TB) had a median survival of 1.9-7.6 years (indexed from diagnosis), compared with 2.9-6.5 years for extensively drug-resistant tuberculosis (XDR-TB) and 2.0-8.0 years for Non- MDR -TB. Notably, untreated MDR -TB patients presented with particularly unfavorable survival outcomes. Patients coinfected with HIV and tuberculosis (TB/HIV) consistently showed very short survival times, whereas individuals with pneumoconiosis but without tuberculosis had substantially longer survival compared to those with both conditions. Life expectancy estimates revealed that TB/HIV coinfection reduced life expectancy at age 30 to between 4.2 and 21.6 years, in stark contrast to over 35.0 years in individuals with HIV but without tuberculosis. Years of potential life lost analyses indicated that patients with active tuberculosis lost 4.9-15.8 years of potential life, compared to 1.3 years for those with latent tuberculosis infection (LTBI). TB/HIV coinfection further amplified this burden, with losses reaching up to 16.3 years. Using a fixed age cut-off of 69 years, patients with tuberculosis lost an average of 39.1 years of potential life compared with 24.5 years among non-TB controls.
Most studies suggest that tuberculosis shortens survival and increases potential years of life lost, particularly in patients with drug-resistant tuberculosis, TB/HIV coinfection, or untreated tuberculosis, although there is important variation by patient group and study method. Early diagnosis and appropriate treatment may help reduce life loss and improve life expectancy.
结核病对人类健康和寿命有显著影响。我们旨在系统地综合各项研究，总结结核病患者的中位生存时间范围和潜在寿命损失年数（YPLL）。
我们检索了Web of Science、PubMed、中国知网和万方数据，检索时间跨度从各数据库建库至2024年10月1日。纳入报告了药敏或耐药结核病患者中位生存时间或YPLL的研究，主要涉及成年参与者。两名评审员独立筛选研究并提取数据。任何分歧都通过协商一致或由第三位评审员仲裁解决。
本分析共纳入22项研究。耐多药结核病（MDR-TB）患者的中位生存期为1.9至7.6年（从诊断起计算），广泛耐药结核病（XDR-TB）患者为2.9至6.5年，非MDR-TB患者为2.0至8.0年。值得注意的是，未经治疗的MDR-TB患者生存结果尤其不佳。合并感染艾滋病毒和结核病（TB/HIV）的患者生存时间一直非常短，而患有尘肺病但未患结核病的个体与同时患有这两种疾病的个体相比，生存期要长得多。预期寿命估计显示，TB/HIV合并感染使30岁时的预期寿命降低至4.2至21.6年之间，这与感染艾滋病毒但未患结核病的个体超过35.0年形成鲜明对比。潜在寿命损失年数分析表明，活动性结核病患者损失了4.9至15.8年的潜在寿命，而潜伏性结核感染（LTBI）患者为1.3年。TB/HIV合并感染进一步加重了这一负担，损失高达16.3年。使用69岁的固定年龄界限，结核病患者平均损失39.1年的潜在寿命，而非结核病对照组为24.5年。
大多数研究表明，结核病会缩短生存期并增加潜在寿命损失年数，特别是在耐药结核病患者、TB/HIV合并感染患者或未经治疗的结核病患者中，尽管不同患者群体和研究方法存在重要差异。早期诊断和适当治疗可能有助于减少寿命损失并提高预期寿命。
