Rationale: Individuals surviving tuberculosis (TB) disease may experience chronic sequelae that reduce survival and quality of life. These post-TB sequalae are not generally considered in estimates of the health impact of TB disease.

Objectives: To estimate the TB-attributable reductions in life expectancy and quality-adjusted life expectancy for individuals developing TB disease in the United States, including post-TB sequelae.

Methods: We extracted national surveillance data on individuals with diagnoses of TB from 2015 to 2019, including demographics, vital status at diagnosis, treatment duration, treatment outcome, and coprevalent conditions. Using a mathematical model, we simulated life expectancy and quality-adjusted life-years (QALYs) for the TB cohort compared with a no-TB counterfactual (with the same distributions of age, sex, race/ethnicity, and coprevalent conditions as the TB cohort but without TB-attributable mortality and disutility). We disaggregated results to report the proportions of QALYs and life-years lost from TB due to post-TB sequelae and stratified outcomes by age, sex, and race.

Measurements and Main Results: Estimated life expectancy after TB diagnosis was 30.3 (95% uncertainty interval, 29.9–30.7) years for the TB cohort versus 32.3 (31.9–32.7) years without TB, a difference of 2.03 (1.84–2.21) years and 1.93 (1.69–2.18) QALYs. Life-years lost were greatest for individuals 65–74 years of age versus other age groups, for men versus women, and for American Indian or Alaska Native individuals versus persons from other races/ethnicities. Overall, 41% (35–46%) of life-years and 48% (42–54%) of QALYs lost were estimated to result from post-TB sequelae.

Conclusions: In the United States, a substantial fraction of life-years and QALYs lost from TB are attributable to post-TB sequelae. Evidence is needed on approaches to prevent and repair post-TB lung damage in the context of frequent coprevalent health conditions.