TB and interstitial lung disease: a systematic review and meta-analysis

I N T R O D U C T I O N: To determine the frequency of TB among patients with interstitial lung diseases (ILDs). M E T H O D S: We performed a comprehensive search in the PubMed/Medline, EMBASE and Scopus databases up to 1 August 2023 of studies reporting on the prevalence of TB among patients with ILDs. R E S U L T S: Twelve studies comprising 3,817 patients with ILD were found: the pooled prevalence of TB among ILD patients was 11.0% (95% CI 5.4–21.0). In the subgroup analysis, the TB rate among patients with silicosis and idiopathic pulmonary fibrosis (IPF) was respectively 35.6% (95% CI 32.6–38.8) and 4.4% (95% CI 3.6–5.3) (P ¼ 0.00). The frequency of TB among ILD patients was higher in high TB burden countries than in low/intermediate-burden countries: 26.3%, 95% CI 17.7–37.3 vs. 4.9%, 95% CI 3.3–7.2; P ¼ 0.00. C O N C L U S I O N S: This study shows the frequency of TB among ILD patients. The meta-analysis reveals a significantly increased prevalence of TB among ILD patients with silicosis compared to IPF, and among individuals in high TB burden countries than in those with low/intermediate burden. The study results can help physicians and policymakers make efficient decisions for prompt screening and anti-TB treatment initiation in ILD patients.