Aspergillus fumigatus and aspergillus flavus-specific IGG cut-offs for the diagnosis of chronic pulmonary aspergillosis in Pakistan

Kauser Jabeen, Joveria Farooqi, Nousheen Iqbal, Khalid Wahab, Muhammad Irfan

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Despite a high burden of chronic pulmonary aspergillosis (CPA) in Pakistan, Aspergillus-specific IgG testing is currently not available. Establishing cut-offs for Aspergillus-specific IgG for CPA diagnosis is crucial due to geographical variation. In settings such as Pakistan, where non-Aspergillus fumigatus (mainly A. flavus) Aspergillus species account for the majority of CPA cases, there is a need to explore additional benefit of Aspergillus flavus-specific IgG detection along with A. fumigatus-specific IgG detection. This study was conducted at the Aga Khan University, Karachi, Pakistan after ethical approval. Serum for IgG detection were collected after informed consent from healthy controls (n = 21), diseased controls (patients with lung diseases, n = 18), and CPA patients (n = 21). A. fumigatus and A. flavus IgG were detected using Siemens immulite assay. The sensitivity and specificity of A. fumigatus-specific IgG were 80.95% and 82.05%, respectively at a cut-off of 20 mg/L. The sensitivity and specificity of A. flavus-specific IgG were 80.95% and 79.49% at a cut-off of 30 mg/L. We report, for the first time, performance of A. flavus-specific IgG for CPA diagnosis. Although there was no statistically significant difference between the performance of both antigens, it seems contextually relevant to include A. flavus IgG in the CPA diagnostic algorithm in regions with higher non-A. fumigatus CPA infections.

Original languageEnglish
Article number249
Pages (from-to)1-8
Number of pages8
JournalJournal of Fungi
Volume6
Issue number4
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Aspergillus IgG
  • Aspergillus flavus
  • Aspergillus fumigatus
  • Chronic pulmonary aspergillosis
  • Pakistan
  • Siemens immulite

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