Clinical Performance of the Aspergillus Western Blot IgG Kit for Serodiagnosis of Chronic Pulmonary Aspergillosis in Post-Tuberculosis Patients

Authors

  • Anna Rozaliyani 1 Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia 2 The Indonesian Society of Respirology, Jakarta, Indonesia 3 The Indonesia Pulmonary Mycoses Centre Faculty of Medicine Universitas Indonesia – National Respiratory Referral Hospital Persahabatan, Jakarta, Indonesia
  • Sresta Azahra 4 Magister Program of Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Findra Setianingrum 1 Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia 3 The Indonesia Pulmonary Mycoses Centre Faculty of Medicine Universitas Indonesia – National Respiratory Referral Hospital Persahabatan, Jakarta, Indonesia
  • Heri Wibowo 1 Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia 3 The Indonesia Pulmonary Mycoses Centre Faculty of Medicine Universitas Indonesia – National Respiratory Referral Hospital Persahabatan, Jakarta, Indonesia

DOI:

https://doi.org/10.36497/jri.v43i4.562

Keywords:

Chronic Pulmonary Aspergillosis, Tuberculosis, Western blot

Abstract

Background: Chronic pulmonary aspergillosis (CPA) by Aspergillus spp., which causes slowly progressive destruction to lung parenchyma, is a major complication of pulmonary tuberculosis (TB). Clinical and radiological features of CPA are not typical and might resemble TB. Therefore, detecting Aspergillus-specific IgG is critical for diagnosing CPA.

Methods: This cross-sectional study was conducted to evaluate the performance of Aspergillus Western Blot (Asp-WB) IgG kit (LDBio Diagnostics, Lyon, France) for CPA diagnosis in 63 post-TB patients. The analysis was performed by comparing Asp-WB with Aspergillus ELISA IgG (Asp-ELISA) and fungal culture as standard method.

Results: Of the 63 patients studied, twenty six (41%) met the probable CPA criteria. The Asp-WB results were positive in 13 probable CPA patients and 3 non-CPA patients, with the significant difference of 50% vs. 8% (p< 0.001). The sensitivity and specificity of Asp-WB were 50% and 93%. False negative results of Asp-WB were detected from non-fumigatus CPA that grew Aspergillus niger. CPA patients with mild symptoms (less than 3 months) indicated early progression of CPA might showed positive Asp-WB test result in low sensitivity of Asp-WB test.

Conclusion: The Asp-WB has potential to use as confirmatory test to assist diagnosis of CPA in post-TB patients.

Downloads

Download data is not yet available.

References

WHO. Global tuberculosis report 2021. Geneva: World Health Organization; 2021.

Page ID, Byanyima R, Hosmane S, Onyachi N, Opira C, Richardson M, et al. Chronic pulmonary aspergillosis commonly complicates treated pulmonary tuberculosis with residual cavitation. Eur Respir J. 2019; 53: 1-8.

Chakaya J, Kirenga B, Getahun H. Long term complications after completion of pulmonary tuberculosis treatment: a quest for a public health approach. J Clin Tuberc Other Mycobact Dis. 2016; 3:1-8.

Rozaliyani A, Rosianawati H, Handayani D, Agustin H, Zaini J, Syam R, et al. Chronic pulmonary aspergillosis in post tuberculosis patients in Indonesia and the role of LDBio Aspergillus ICT as part of the diagnosis scheme. J Fungi. 2020; 6: 1-10.

Nguyen NTB, Le Ngoc H, Nguyen NV, Van Dinh L, Van Nguyen H, Nguyen HT, et al. Chronic pulmonary aspergillosis situation among post tuberculosis patients in Vietnam: An observational study. J Fungi. 2021; 7: 532: 1-10.

Lakhtakia L, Spalgais S, Kumar R. Spectrum of pulmonary aspergillus diseases in post TB lung diseases. Indian J Tuberc. 2022; 69: 523-9.

Denning DW, Pleuvry A, Cole DC. Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis. Bulletin of the World Health Organization. 2011; 89: 864-72.

Wahyuningsih R, Adawiyah R, Sjam R, Prihartono J, Ayu Tri Wulandari E, Rozaliyani A, et al. Serious fungal disease incidence and prevalence in Indonesia. Mycoses. 2021; 64:1203-12.

Setianingrum F, Rozaliyani A, Adawiyah R, Syam R, Tugiran M, Sari CYI, et al. A prospective longitudinal study of chronic pulmonary aspergillosis in pulmonary tuberculosis in Indonesia (APICAL). Thorax. 2022; 77: 821-8.

Denning DW, Page ID, Chakaya J, Jabeen K, Jude CM, Cornet M, et al. Case definition of chronic pulmonary aspergillosis in resource-constrained settings. Emerg Infect Dis. 2018; 24: e1-13.

Page ID, Richardson MD, Denning DW. Comparison of six Aspergillus-specific IgG assays for the diagnosis of chronic pulmonary aspergillosis (CPA). J Infect. 2016; 72: 240–9.

Page ID, Richardson MD, Denning DW. Siemens Immulite Aspergillus-specific IgG assay for chronic pulmonary aspergillosis diagnosis. Med Mycol. 2019; 57: 300-7.

Baxter CG, Denning DW, Jones AM, Todd A, Moore CB, Richardson MD. Performance of two Aspergillus IgG EIA assays compared with the precipitin test in chronic and allergic aspergillosis. Clin Microbiol Infect. 2013; 19: e197-204.

Richardson M, Page I. Role of Serological Tests in the Diagnosis of Mold Infections. Current Fungal Infection Reports. 2018;12: 127-36.

Rozaliyani A, Setianingrum F, Azahra S, Abdullah A, Fatril AE, Rosianawati H, et al. Performance of LDBio Aspergillus WB and ICT antibody detection in chronic pulmonary aspergillosis. J Fungi. 2021; 7: 1-9.

Oliva A, Flori P, Hennequin C, Dubus JC, Reynaud-Gaubert M, Charpin D, et al. Evaluation of the Aspergillus Western blot IgG kit for diagnosis of chronic aspergillosis. J Clin Microbiol. 2015; 53: 248-54.

Rozaliyani A, Abdullah A, Setianingrum F, Sjamsuridzal W, Wahyuningsih R, Bowolaksono A, et al. Unravelling the Molecular Identification and Antifungal Susceptibility Profiles of Aspergillus spp. Isolated from Chronic Pulmonary Aspergillosis Patients in Jakarta, Indonesia: The Emergence of Cryptic Species. J Fungi. 2022; 8: 1-8.

Downloads

Published

2023-10-31

Issue

Section

Original Article

Similar Articles

1-10 of 149

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)