Stages of tuberculosis disease can be delineated by radiology, microbiology, and symptoms,
but transitions between these stages remain unclear. In a systematic review and meta-analysis
of studies of individuals with untreated tuberculosis who underwent follow-up (34
cohorts from 24 studies, with a combined sample of 139 063), we aimed to quantify
progression and regression across the tuberculosis disease spectrum by extracting
summary estimates to align with disease transitions in a conceptual framework of the
natural history of tuberculosis.
In the absence of RCTs, our individual patient data network meta-analysis indicates
that 3HP provided an increase in treatment completion over 4R, but was associated
with a higher risk of adverse events. Although findings should be confirmed, the trade-off
between completion and safety must be considered when selecting a regimen for tuberculosis
preventive treatment.