Serological Changes in Anti-Aspergillus IgG Antibody and Development of Chronic Pulmonary Aspergillosis in Patients Treated for Pulmonary Tuberculosis

Serological Changes in Anti-Aspergillus IgG Antibody and Development of Chronic Pulmonary Aspergillosis in Patients Treated for Pulmonary Tuberculosis

Author:

Changwhan Kim, Jin-Wook Moon, Yong-Bum Park and Yousang Ko

Date: 28 January 2022

Abstract:

Abstract: Chronic pulmonary aspergillosis (CPA) is an important infection to understand in survivors of pulmonary tuberculosis (PTB). However, limited data are available regarding CPA development and its predisposing factors following PTB. We investigated the development of, and the
predisposing factors for, CPA following the completion of PTB treatment. A total of 345 patients,
with newly diagnosed culture-positive PTB (between January 2015 and December 2018), were included. Enrolled cases were categorized into four groups (persistently seronegative, seroconversion,
seroreversion, and persistently seropositive) according to serological changes in their anti-Aspergillus IgG antibodies before and after PTB treatment. The patients were followed up for a median of
25.8 months. Ten (10/345, 2.9%) patients developed CPA at a median of 13.5 months after treatment
completion, including seven (7/24, 29.2%) and three (3/73, 4.1%) in the seroconversion and persistently seropositive groups, respectively. Upon multivariate analysis, seroconversion of anti-Aspergillus IgG antibody (adjusted hazard ratio [HR], 25.21; 95% confidence interval [CI], 6.11–103.99; p
< 0.001) and diabetic status (adjusted HR, 7.54; 95% CI, 1.93–29.50; p = 0.004) were independently
associated with CPA development. The development of CPA in patients with PTB was observed in
2.9% of patients during post-treatment follow-up, and this was significantly associated with both
the seroconversion of anti-Aspergillus IgG antibody and diabetes characteristics.
Keywords: pulmonary tuberculosis; chronic pulmonary aspergillosis; anti-AspergillusIgG antibody;
seroconversion; serological change

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