Patients with spinal tuberculosis complicated with HIV/AIDS have multiplied the difficulty of treatment due to low immune function. To standardize the procedures for diagnosis and treatment in patients with spinal tuberculosis complicated with HIV/AIDS, and to increase peer awareness of the details of the treatment of such diseases, and to have a reliable basis for their treatment, we organized the Professional Branch of Chinese Antituberculosis Association, the Western China Bone Tuberculosis Alliance, the North China Bone Tuberculosis Alliance and the Editorial Board of Chinese Journal of Antituberculosis to jointly develop the experts’ consensus on the diagnosis and treatment of patients with spinal tuberculosis complicated with HIV/AIDS. Some items including the epidemiological background, the common clinical manifestations, laboratory examination, diagnostic criteria, drugs usage, surgical treatment, occupational exposure during surgery,announcements and relative research have been formulated and discussed on these patients with spinal tuberculosis complicated with HIV/AIDS in this experts’ consensus.

The occurrence, development and prognosis of tuberculosis (TB) depend on the quantity and virulence of MTB and immune resistance. The analysis of lymphocyte subsets in peripheral blood of TB patients by flow cytometry can help to evaluate the immune status, immune function and immune balance of TB patients, and provide experimental basis for clinical development of immune intervention measures, observation of curative effect and judgment of prognosis. This expert consensus briefly introduces lymphocyte subsets analysis items (including percentage and absolute count) commonly used in clinic; puts forward the suggestions for the detection of lymphocyte subsets in TB patients and the correct interpretation of the results; introduces the use of lymphocyte subsets analysis in the clinical diagnosis and treatment of TB patients, and prospects the development of lymphocyte subsets detection in the future.

For the treatment of non-tuberculous mycobacterial disease drugs or no indication, or over-treatment, over-dose, etc. The Non-tuberculous Mycobacterial Branch of the Chinese Antituberculosis Association organized relevant experts on treatment drugs such as macrolides, rifamycin, aminoglycosides, fluoroquinolones, β-lactams, tetracyclines, linezolid, clofazimine, bedaquiline, trimethoprim-sulfamethoxazole and other drugs for non-tuberculous mycobacterial disease to reach a consensus, looking forward to providing guidance to clinicians.

Active discovery and preventive treatment is the core measure of tuberculosis control of the global strategy for ending tuberculosis epidemic. China is one of the countries with high burden of tuberculosis in the world. For the goal of ending tuberculosis in the world, strengthening the active discovery of latent tuberculosis infection (LTBI), screening the close contacts of tuberculosis patients, and preventive treatment for the newly infected and immunocompromised LTBI populations are important measures to reduce the incidence of LTBI. However, there are still many doubts and disputes about the applicable objects, regimes and effect of preventive treatment now. New diagnostic techniques and preventive treatment methods are constantly studied and applied. In view of this, experts from Chinese Antituberculosis Association have compiled the Expert consensus on detection and preventive treatment of latent tuberculosis infection in high-risk population, and reviewed the principle and detection of LTBI, and objects of prevention treatment, diagnostic methods, chemical prevention and immunization prevention, to provide reference for Chinese tuberculosis control workers.

The tuberculosis epidemic is still severe, and new anti-tuberculosis drugs are urgently needed. Clinical trials of new drugs are the most important stage of new drug development. Early bactericidal activity (EBA) is the first step in clinical study of new anti-tuberculosis drugs used in the treatment of tuberculosis patients, and it is also the key of clinical evaluation of the single anti-tuberculosis drug and a new regimen. In order to standardize and better promote the development of new anti-tuberculosis drugs in China, after repeated discussions by experts in the field of tuberculosis clinical and basic research organized by Beijing Chest Hospital affiliated to Capital Medical University and the Editorial Board of Chinese Journal of Antituberculosis, the Expert consensus on the study of early bactericidal activity of new anti-tuberculosis drugs has been formulated on the significance, design, implementation, and influencing factors of the EBA study on the new anti-tuberculosis drugs.

The occurrence, development and prognosis of tuberculosis (TB) are closely related to immune resistance. The detection of peripheral blood lymphocyte subsets in TB patients is one of the methods to evaluate immune function, but the clinical application of this detection in TB is limited and the understanding is not uniform. “Expert consensus on detection and clinical application of peripheral blood lymphocyte subsets in patients with tuberculosis” published in No.10 of 2020 in Chinese Journal of Antituberculosis proposed specific suggestions and reached consensus on correct interpretation and clinical application of lymphocyte subsets detection results. This interpretation emphasizes that we should pay attention to the standardization and normalization of detection methods for peripheral blood lymphocyte subsets in TB patients, pay attention to the comprehensive, correct and objective analysis of the detection results, and put forward brief suggestions on the existing problems, to provide the reference of TB clinical workers of our country.

This standard stipulates the principles, institutional requirements, inspection items, service modes, data management and utilization requirements for carrying out the health check-up for rural residents. It is applicable to the standardized management of the health check-up for rural residents aged 15 years old and above under the relevant national laws and regulations.

The global modern tuberculosis control strategy puts forward that the anti-tuberculosis drugs should be continuously supplied to the patients with pulmonary tuberculosis, and the standardized short-term chemotherapy regimen and the whole-course management should be implemented to the patients with new pulmonary tuberculosis. The purpose is to improve the regular treatment rate and cure rate of the patients with pulmonary tuberculosis. In order to further improve the treatment compliance of patients with tuberculosis, reduce the number of drugs taken by patients each time, simplify the prescription of medicine prescribed by doctors, and prevent the occurrence of drug-resistant tuberculosis caused by unreasonable prescription and dosage. In 1994, WHO and IUATLD recommended the use of fixed dose combination (FDC) of anti-tuberculotic drugs in patients with tuberculosis. Since the beginning of this century, China had carried out a number of implementation studies on the application of FDC consecutively in different provinces. The results show the feasibility and effectiveness of FDC in the treatment of tuberculosis, and provide an important scientific basis for FDC to be included in the national tuberculosis control program. This consensus has been repeatedly discussed by experts in the fields of tuberculosis prevention and control, clinicians and researchers. Based on the significance of use, pharmacodynamics and pharmacokinetics, a number of application research results of FDC, preparation types and specifications of FDC, and suggestions for clinical use of FDC in China, the experts formed ‘the consensus on clinical use of fixed dose combinations of anti-tuberculosis drugs’ which provides reference for formulating the use strategy of anti-tuberculosis drugs and the treatment of tuberculosis patients in China.

Therapeutic drug monitoring (TDM) is an individualized administration guided by determining the drug exposure, pharmacological markers or efficacy indicators in patients, by using quantitative pharmacological model and taking the drug treatment window as the benchmark. In the process of anti-tuberculosis treatment, there are many problems such as individual differences in drug concentration and various adverse effects, which may lead to treatment failure, drug resistance and recurrence. The use of anti-tuberculosis drugs TDM can optimize drug treatment, improve drug efficacy and reduce toxic and side effects. In order to promote the standardization of tuberculosis TDM in China, ensure the scientificity, ethics and legality of TDM, and maximize the benefits of patients, the Expert Consensus on the Therapeutic Drug Monitoring of Anti-Tuberculosis Drugs was composed. This consensus has been repeatedly discussed by experts in the fields of tuberculosis, including clinicians and pharmacologists. Based on the significance, indications, detection methods, implementation process and quality control of TDM, the experts generated the consensus.

On November 9, 2017, the National Health and Family Planning Commission of the People’s Republic of China issued a new health standard for the Classification of tuberculosis (WS 196-2017), which will be formally implemented on May 1, 2018. By the introduction of tracheobronchial tuberculosis incidence, clinical features, diagnosis, classification and treatment methods in WS 196-2017 standard, this paper focuses on the clinical diagnosis of tracheobronchial tuberculosis and especially provides a feasible reference for the key roles of bronchoscopy in the diagnosis and interventional treatment of tracheobronchial tuberculosis.

Isoniazid (INH) is one of the core drugs in the anti-tuberculosis (anti-TB) treatment regimens, and its catabolic speed is dependent on the activity of N-acetyltransferase-2 (NAT2). According to polymorphisms of the enzyme encoding gene NAT2, patients could be categorized as slow, intermediate or fast acetylators. The significant blood concentration difference was found in the deployment of uniform INH dosage for different TB patients, it could influence the treatment outcome and the occurrence of adverse drug reactions. To promote more scientific and canonical NAT2 gene polymorphism detection and acetylator type judgement, and then guide the appropriate isoniazid dosing for tuberculosis patients, experts in the field of tuberculosis treatment and pharmacology organized by Beijing Chest Hospital and the Editorial Board of Chinese Anti-tuberculosis Journal composed a consensus with the existing guidelines and published professional literature. This consensus includes the method of acetylator type categorization, the pharmacokinetic features, the influences on treatment outcome and adverse drug reactions, the dose adjustment principle of isoniazid for different acetylator types, and the important concerns on NAT2 polymorphism detection.

Drug-resistant tuberculosis (DR-TB) especially multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are one of the most difficult problems to be solved in clinical practice. Anti-tuberculous drug susceptibility tests (DST) provide experimental basis for the diagnosis of DR-TB. This expert consensus briefly introduces the common M.tuberculosis (MTB) DST methods (including phenotypic DST and molecular DST) used in clinic, proposes the strategies of MTB drug resistance detection and correct interpretation of the results, points out the problems of DST detection technology and clinical application, and prospects the development of DST in the future.

The comorbidity of tuberculosis (TB) and diabetes (DM) is becoming a big clinical challenge. It requires physicians from TB and DM teams to work together to decide treatment plans and conduct follow-up management in order to further increase cure rate and reduce mortality. The Expert consensus on treatment and management of tuberculosis-diabetes mellitus comorbidity was published on the first issue of 2021 in the Chinese Journal of Antituberculosis. This consensus offered management recommendations for frequently met problems during the treatment of TB-DM. We hereby further interpret the concept of TB-DM comorbidity, the management of diabetes, adverse drug reactions and precautions during treatment for clinicians in our country when taking care of patients with TB-DM.

Clinical diagnosed pulmonary tuberculosis (TB), known as TB cases without pathogenic evidence. Because of lacking typical clinical symptoms, misdiagnosis is not rare in clinical practice. The newly released national standard on Diagnosis for pulmonary tuberculosis (WS 288-2017) sets up a new criteria for clinical diagnosed TB case with consideration of current new diagnostic tools. This paper aims to interpret the new national standard on clinical diagnosed TB case, and provide guidance to clinicians’ routine practice.

With the development of global tuberculosis prevention and control strategy, continuous and in-depth research on screening and prevention of high-risk groups, and inactive pulmonary tuberculosis is as a high-risk group, more and more attention has been paid by the international community. However, diagnosis procedures and requirements of inactive tuberculosis is not clear, research on the development of inactive tuberculosis into active tuberculosis are insufficient, and no intervention measures on inactive tuberculosis have been taken into the high-risk population of tuberculosis in China.To strengthen the understanding to inactive pulmonary tuberculosis, standard the diagnostic method of inactive tuberculosis, formulate the prevention and cure measure of inactive tuberculosis to develop active tuberculosis. Thus, Chinese Antituberculosis Association organized experts in tuberculosis control, clinical, imaging and research fields to write the China’s Expert consensus on diagnosis of inactive pulmonary tuberculosis. This consensus puts forward the definition and diagnosis evidence of inactive tuberculosis, analyzes the risk of the occurrence of inactive tuberculosis, and puts forward the measures to prevent the occurrence of inactive tuberculosis, which provides reference for improving the prevention strategy and vaccine research of the high-risk population of tuberculosis in China.

BCG vaccine is of great significance in preventing tuberculosis.China adopts the strategy of vaccinating newborns with BCG vaccine at birth.In this paper, the author discussed the quality control standards of BCG vaccine of domestic and foreign, the general situation of BCG vaccine strains in China, the induced immune response and adverse reactions of BCG vaccine in China, so as to provide basic information for understanding BCG vaccines in China.

In order to meet the needs of the current tuberculosis prevention and control work in China,the National Health and Family Planning Commission (NHFPC) released the health industry standard for the Classification of tuberculosis (WS 196-2017) on November 9, 2017. The new classification standards are based on the etiology, epidemiological characteristics, clinical manifestations, laboratory tests and differential diagnosis of tuberculosis. Amendments mainly focus on active TB, and it is in line with the characteristics of the change and development of tuberculosis. The trachea and bronchial tuberculosis and tuberculous pleurisy are incorporated into pulmonary tuberculosis. And the molecular and bacteriological examination result are defined as pathogenic examination. At the same time, the results of drug susceptibility test are included in the active tuberculosis classification. This standard also cover Mycobacterium tuberculosis latent infection and inactive pulmonary tuberculosis. The clear definition of the two groups are more conducive to the key prevention and control of tuberculosis. Increasing the drug resistance classification is beneficial to understand the status of drug-resistant tuberculosis and to evaluate the epidemic status of drug-resistant tuberculosis scientifically and objectively. The Classification of tuberculosis (WS 196-2017) will provide a strong technical support for the realization of the goal of ending tuberculosis prevention and control in China in 2035.

The global incidence of tuberculosis has declined marginally from 2000 to 2017, but it is still under poor control in parts of Africa and Asia. Multidrug-resistant tuberculosis (MDR-TB) has become a major concerned issue in the global public health system, and the optimum medications and treatment regimens for MDR-TB remain controversial. This review summarizes the treatment guidelines for MDR-TB in recent years and analyzes the background, specific recommendations, implementations and trends of these guidelines.

To interpret the “Treatment of Drug-resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline (ATS Guideline)”, including the drugs, formulating treatment regimen and duration, as well as treatment of isoniazid-resistant TB, preventive therapy of close contacts of MDR-TB; and then to compared “ATS Guideline” with “Guideline for Chemotherapy of Drug Resistant Tuberculosis (2019)” in China.

Drug-resistant tuberculosis (TB) has the characteristics of long treatment course, regimens with variety of drugs,high incidence rate of drug side-effect, how to treat drug side-effect correctly is one of essential factors of improving the outcome of drug-resistant tuberculosis. This expert consensus will elaborate in the treatment of side-effects from each drug and each system,treatment monitoring for drug side-effect and will provide the normative methods and principles for side-effects of drugs.

School students in crowed environment are susceptible to tuberculosis(TB), often resulting outbreaks and public health emergencies. We give further advices on the investigation of index cases and their close contacts, diagnosis and treatment of active TB patients and latent TB infection and their standardized management, aiming at facilitating TB epidemiology investigation, scene disposal and related effect evaluation.

Drug-resistant tuberculosis is a difficult problem in the field of TB treatment.Spinal tuberculosis is a common extrapulmonary secondary tuberculosis. Drug resistance seriously affects the therapeutic effect and prognosis of spinal tuberculosis.This expert consensus provides a brief introduction to the definition and epidemiology of drug-resistant spinal tuberculosis, proposes the diagnostic criteria and methods of drug-resistant spinal tuberculosis, puts forward some suggestions on the formulation of anti-tuberculosis treatment, the choice of surgical timing and surgical methods, prospects the research development of drug-resistant spinal tuberculosis in the future.

The epidemic situation of pulmonary tuberculosis in China is challenging. Pathogenic test of Mycobacterium tuberculosis is the “golden indicator” for the diagnosis of pulmonary tuberculosis, but the activity judgment becomes difficult when the etiological examination is negative. In addition, evaluation of activity of pulmonary tuberculosis post-treatment also encounters the pathogenic problem. This expert consensus introduces the current evaluation methods for activity judgment of pulmonary tuberculosis, and sets standards of clinical comprehensive evaluation of activity. Meanwhile, it points out the existing problems of activity judgment and its clinical implementation and discusses its future development.