Elevated Aspergillus-specific antibody levels among HIV infected Ugandans with pulmonary tuberculosis.

TitleElevated Aspergillus-specific antibody levels among HIV infected Ugandans with pulmonary tuberculosis.
Publication TypeJournal Article
Year of Publication2017
AuthorsKwizera, R, Parkes-Ratanshi, R, Page, ID, Sekaggya-Wiltshire, C, Musaazi, J, Fehr, J, Castelnuovo, B, Kambugu, A, Denning, DW
JournalBMC Pulm Med
Volume17
Issue1
Pagination149
Date Published2017 Nov 21
ISSN1471-2466
Abstract

BACKGROUND: The incidence of tuberculosis (TB) is high among human immunodeficiency virus (HIV) infected Ugandans. Recent evidence suggests that Chronic Pulmonary Aspergillosis and Aspergillus sensitisation might be responsible for significant mortality in patients treated for tuberculosis in Uganda.

METHODS: We retrieved and tested paired serum aliquots for 101 HIV-TB co-infected patients at the beginning and week 24 of TB treatment. We tested samples for Aspergillus-specific immunoglobulin G (IgG) and immunoglobulin E (IgE) using ImmunoCAP®; and Aspergillus-specific IgG and total serum IgE using Immulite® immunoassays. We compared antibody levels between baseline and week 24, relating them to selected baseline characteristics.

RESULTS: 10% of the patients had elevated Aspergillus-specific IgE (Aspergillus sensitization) and Aspergillus-specific IgG antibodies were elevated in 9% of the patients at the end of TB treatment. There was a significant fall in the Aspergillus-specific IgG antibody levels between baseline and week 24 (P = 0.02). Patients with cluster of differentiation 4 (CD4) T-cell count

CONCLUSION: These results suggest that Aspergillus infection may complicate active pulmonary TB and further studies including fungal culture and thoracic imaging may now be indicated to measure the prevalence of pulmonary aspergillosis complicating tuberculosis.

TRIAL REGISTRATION: The SOUTH trial was registered prospectively. ClinicalTrials.gov Identifier: NCT01782950 ; Registration date: 4th February 2013; Last verified: 13th April 2015.

DOI10.1186/s12890-017-0500-9
Alternate JournalBMC Pulm Med
PubMed ID29162063
PubMed Central IDPMC5699185