Impact of high baseline Aspergillus-specific IgG levels on weight and quality-of-life outcomes of patients with chronic pulmonary aspergillosis
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Date
2020-04-02
Journal Title
Journal ISSN
Volume Title
Publisher
Medical Mycology
Abstract
This study aimed to evaluate the impact of quantitative baseline Aspergillus-specific immunoglobulin G (IgG)
serum levels on weight changes of patients with chronic pulmonary aspergillosis (CPA) under antifungal
treatment. We retrospectively reviewed data of patients diagnosed with CPA between April 2015 and March
2018 at the National Aspergillosis Centre (Manchester, UK). All patients were on continued antifungal treat ment for 12 months. Data on Aspergillus-specific IgG levels, St George’s quality of life (SGQoL) variables and
weight at baseline, 6 months and 12 months were extracted. We defined a high serum Aspergillus-specific
IgG as ≥ 200 mg/l (Group A) and low level < 200 mg/l (Group B). Forty-nine patients (37 male; 12 female),
median age 65 years (range: 29–86) were studied. Overall, 33% (n = 16) of the patients were in Group A. The
baseline characteristics between the two groups were similar. The median Charlson comorbidity index was
4 (range: 0–5) and 3 (range: 0–9) for Group A and Group B, respectively (P = .543). There was a sustained
decline in median Aspergillus IgG levels from baseline, through 6 month to 12 months of continues therapy
from 170 (range: 20–1110) to 121 (range: 20–1126), and finally 107 (15–937) mg/l, respectively (P < .001). Group
A patients gained more weight at 6 months (9/15 [60%] vs. 7/33 [21%], P = .012) and at 12 months of treatment
(9/15 [60%] vs. 7/33 [22%]), and more patients in Group B lost weight ((13/33 [41%] vs. 1/15 [7%]), P = .015).
However, there was no difference in QoL outcomes across groups at 6 (P = .3) and 12 (P = .7) months. A
very high Aspergillus IgG may confer a higher likelihood of weight gain as a key, objective marker of clinical
response, if patients can tolerate 12 months of antifungal therapy.
Description
Keywords
Aspergillus IgG,, CPA,, weight,, and quality of life
Citation
Bongomin, F., Garcez, T., & Denning, D. W. (2020). Impact of high baseline Aspergillus-specific IgG levels on weight and quality-of-life outcomes of patients with chronic pulmonary aspergillosis. Medical Mycology, 58(7), 1000-1004.