{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:27:36Z","timestamp":1793755656681,"version":"4.6.1"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2019R1G1A1099940"],"award-info":[{"award-number":["NRF-2019R1G1A1099940"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>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\u2013103.99; p &lt; 0.001) and diabetic status (adjusted HR, 7.54; 95% CI, 1.93\u201329.50; 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.<\/jats:p>","DOI":"10.3390\/jof8020130","type":"journal-article","created":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T05:26:17Z","timestamp":1643433977000},"page":"130","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Serological Changes in Anti-Aspergillus IgG Antibody and Development of Chronic Pulmonary Aspergillosis in Patients Treated for Pulmonary Tuberculosis"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3318-2528","authenticated-orcid":false,"given":"Changwhan","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Jeju National University Hospital, Jeju National University, Jeju 63241, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Wook","family":"Moon","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Bum","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1703-6590","authenticated-orcid":false,"given":"Yousang","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"ref_1","unstructured":"World Health Oranization (2021, January 24). Global Tuberculosis Report 2020. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240013131."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1159\/000512531","article-title":"Post-Tuberculosis Lung Disease: Clinical Review of an Under-Recognised Global Challenge","volume":"100","author":"Allwood","year":"2021","journal-title":"Respiration"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Chakraborti, S., Sarkar, J., Pramanik, P.K., and Chakraborti, T. (2017). Role of proteases in lung disease: A brief overview. Proteases Hum. Dis., 333\u2013374.","DOI":"10.1007\/978-981-10-3162-5_16"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"820","DOI":"10.5588\/ijtld.20.0067","article-title":"Post-tuberculosis lung health: Perspectives from the First International Symposium","volume":"24","author":"Allwood","year":"2020","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1183\/13993003.00583-2015","article-title":"Chronic pulmonary aspergillosis: Rationale and clinical guidelines for diagnosis and management","volume":"47","author":"Denning","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1093\/jac\/dkx390","article-title":"A CPAnet consensus statement on research priorities for chronic pulmonary aspergillosis: A neglected fungal infection that requires attention","volume":"73","author":"Godet","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Lowes, D., Al-Shair, K., Newton, P.J., Morris, J., Harris, C., Rautemaa-Richardson, R., and Denning, D.W. (2017). Predictors of mortality in chronic pulmonary aspergillosis. Eur. Respir. J., 49.","DOI":"10.1183\/13993003.01062-2016"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/ciw326","article-title":"Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America","volume":"63","author":"Patterson","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.5588\/ijtld.17.0060","article-title":"Chronic pulmonary aspergillosis as a cause of smear-negative TB and\/or TB treatment failure in Nigerians","volume":"21","author":"Oladele","year":"2017","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Page, I.D., Byanyima, R., Hosmane, S., Onyachi, N., Opira, C., Richardson, M., Sawyer, R., Sharman, A., and Denning, D.W. (2019). Chronic pulmonary aspergillosis commonly complicates treated pulmonary tuberculosis with residual cavitation. Eur. Respir. J., 53.","DOI":"10.1183\/13993003.01184-2018"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"811","DOI":"10.3109\/13693786.2013.806826","article-title":"Clinical characteristics and treatment outcomes of chronic pulmonary aspergillosis","volume":"51","author":"Jhun","year":"2013","journal-title":"Med. Mycol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.rmed.2012.01.014","article-title":"Clinical characteristics and prognosis of chronic pulmonary aspergillosis","volume":"106","author":"Ohba","year":"2012","journal-title":"Respir. Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Denning, D.W., Page, I.D., Chakaya, J., Jabeen, K., Jude, C.M., Cornet, M., Alastruey-Izquierdo, A., Bongomin, F., Bowyer, P., and Chakrabarti, A. (2018). Case Definition of Chronic Pulmonary Aspergillosis in Resource-Constrained Settings. Emerg. Infect. Dis., 24.","DOI":"10.3201\/eid2408.171312"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"525","DOI":"10.5588\/ijtld.21.0053","article-title":"Diagnosing pulmonary aspergillosis is much easier than it used to be: A new diagnostic landscape","volume":"25","author":"Denning","year":"2021","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/s10096-003-0970-y","article-title":"Significance of Aspergillus fumigatus isolation from respiratory specimens of nongranulocytopenic patients","volume":"22","author":"Uffredi","year":"2003","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1007\/s12281-019-00361-7","article-title":"Diagnostic Aspects of Chronic Pulmonary Aspergillosis: Present and New Directions","volume":"13","author":"Wilopo","year":"2019","journal-title":"Curr. Fungal Infect. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S265","DOI":"10.1086\/376526","article-title":"Chronic cavitary and fibrosing pulmonary and pleural aspergillosis: Case series, proposed nomenclature change, and review","volume":"37","author":"Denning","year":"2003","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1183\/09031936.00054810","article-title":"Underlying conditions in chronic pulmonary aspergillosis including simple aspergilloma","volume":"37","author":"Smith","year":"2011","journal-title":"Eur. Respir. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1007\/s10096-015-2409-7","article-title":"Prevalence of chronic pulmonary aspergillosis in patients with tuberculosis from Iran","volume":"34","author":"Hedayati","year":"2015","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_20","unstructured":"Korea Centers for Disease Control and Prevention (2018). 2017 Annual Report on the Notified Tuberculosis in Korea 2017, Korea Centers for Diseases Control and Prevention. (In Korean)."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Bongomin, F. (2020). Post-tuberculosis chronic pulmonary aspergillosis: An emerging public health concern. PLoS Pathog., 16.","DOI":"10.1371\/journal.ppat.1008742"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Salzer, H.J., and Cornely, O.A. (2017). Awareness of predictors of mortality may help improve outcome in chronic pulmonary aspergillosis. Eur. Respir. J., 49.","DOI":"10.1183\/13993003.02520-2016"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Tuberculosis Association (1970). Aspergilloma and residual tuberculous cavities. The results of a resurvey. Tuber. Lond., 51, 227\u2013245.","DOI":"10.1016\/0041-3879(70)90015-2"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Agarwal, R., Denning, D.W., and Chakrabarti, A. (2014). Estimation of the burden of chronic and allergic pulmonary aspergillosis in India. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0114745"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"864","DOI":"10.2471\/BLT.11.089441","article-title":"Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis","volume":"89","author":"Denning","year":"2011","journal-title":"Bull. World Health Organ."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Setianingrum, F., Rozaliyani, A., Adawiyah, R., Syam, R., Tugiran, M., Sari, C.Y., Nandipinto, F., Arifin, A., Handayani, D., and Burhan, E. (2021). A prospective longitudinal study of chronic pulmonary aspergillosis in pulmonary tuberculosis in Indonesia (APICAL). medRxiv.","DOI":"10.1101\/2021.04.25.21256062"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Volpe Chaves, C.E., do Valle Leone de Oliveira, S.M., Venturini, J., Grande, A.J., Sylvestre, T.F., Poncio Mendes, R., and Mello Miranda Paniago, A. (2020). Accuracy of serological tests for diagnosis of chronic pulmonary aspergillosis: A systematic review and meta-analysis. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0222738"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12890-017-0500-9","article-title":"Elevated Aspergillus-specific antibody levels among HIV infected Ugandans with pulmonary tuberculosis","volume":"17","author":"Kwizera","year":"2017","journal-title":"BMC Pulm. Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Setianingrum, F., Rozaliyani, A., Syam, R., Adawiyah, R., Tugiran, M., Sari, C.Y.I., Burhan, E., Wahyuningsih, R., Rautemaa-Richardson, R., and Denning, D.W. (2020). Evaluation and comparison of automated and manual ELISA for diagnosis of chronic pulmonary aspergillosis (CPA) in Indonesia. Diagn. Microbiol. Infect. Dis., 98.","DOI":"10.1016\/j.diagmicrobio.2020.115124"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Jhun, B.W., Jung, W.J., Hwang, N.Y., Park, H.Y., Jeon, K., Kang, E.S., and Koh, W.J. (2017). Risk factors for the development of chronic pulmonary aspergillosis in patients with nontuberculous mycobacterial lung disease. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0188716"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Shin, S.H., Kim, B.-G., Kang, J., Um, S.-W., Kim, H., Kim, H.K., Kim, J., Shim, Y.M., Choi, Y.S., and Jeong, B.-H. (2020). Incidence and Risk Factors of Chronic Pulmonary Aspergillosis Development during Long-Term Follow-Up after Lung Cancer Surgery. J. Fungi, 6.","DOI":"10.3390\/jof6040271"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kang, N., Park, J., and Jhun, B.W. (2020). Clinical Characteristics and Treatment Outcomes of Pathologically Confirmed Aspergillus Nodules. J. Clin. Med., 9.","DOI":"10.3390\/jcm9072185"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.jinf.2021.07.030","article-title":"Impact of treatment duration on recurrence of chronic pulmonary aspergillosis","volume":"83","author":"Im","year":"2021","journal-title":"J. Infect."}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/8\/2\/130\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:10:12Z","timestamp":1760134212000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/8\/2\/130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,28]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["jof8020130"],"URL":"https:\/\/doi.org\/10.3390\/jof8020130","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,28]]}}}