Importance of <i>Aspergillus</i>-Specific Antibody Screening for Diagnosis of Chronic Pulmonary Aspergillosis after Tuberculosis Treatment: A Prospective Follow-Up Study in Ghana
Bright K. Ocansey | Benjamin Otoo | Hafisatu Gbadamosi | Jane S. Afriyie-Mensah | Japheth A. Opintan | Chris Kosmidis | David W. Denning
Chronic pulmonary aspergillosis (CPA) often occurs in patients that have been previously treated for pulmonary tuberculosis (PTB). A limited number of studies have looked at the development of CPA at different times following the completion of a PTB treatment course. This prospective longitudinal study aimed to determine the incidence of CPA at two timepoints, at the end of the PTB treatment (T<sub>1</sub>) and six months post-treatment (T<sub>2</sub>). Patients with confirmed PTB from a previous study who were placed on anti-TB medication were followed up and screened for CPA at T<sub>1</sub> and T<sub>2</sub> by assessing their symptoms, evaluating their quality of life, and screening them for <i>Aspergillus</i> infection by performing antibody testing and cultures. CPA was defined by the Global Action for Fungal Infections (GAFFI) diagnostic algorithm. Forty-one patients were enrolled, of whom thirty-three patients (80%) and twenty-eight patients (68%) were resurveyed at T<sub>1</sub> and T<sub>2,</sub> respectively. The rate of new CPA was 3.3% (1/33) and 7.4% (2/27) at T<sub>1</sub> and T<sub>2</sub>, respectively, with an overall incidence of 10.7% (3/28) among the patients at both T<sub>1</sub> and T<sub>2</sub>. A positive <i>Aspergillus</i>-specific antibody test was an indicator for CPA in all three patients. <i>Aspergillus</i>-specific antibody screening during and after the end of an anti-TB treatment regimen may be important for early detection of CPA in high-PTB-burden settings.
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