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Published on: March 9, 2018

Prevalence and clinical implications of Aspergillus infection among tuberculosis patients in Peru

Alicia E Madden1, Chuan-Chin Huang2, Roger I Calderon3

  • 1Harvard Medical School, Department of Global Health and Social Medicine, Boston, USA.

The Journal of Infection
|May 23, 2026
PubMed
Abstract

Insights

Aspergillus infection during tuberculosis (TB) treatment is linked to poorer treatment response. Early detection and monitoring for fungal infections are crucial for improving TB patient outcomes.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Aspergillosis is a known complication of post-tuberculosis lung disease.
  • The prevalence and impact of Aspergillus infection during active tuberculosis (TB) treatment remain unclear.
  • Understanding this relationship is vital for optimizing TB patient care.

Purpose of the Study:

  • To determine the prevalence of Aspergillus infection in newly diagnosed TB patients.
  • To assess the association between Aspergillus infection and TB treatment response.
  • To evaluate the impact on final treatment outcomes.

Main Methods:

  • Prospective cohort study in Lima, Peru, involving 1,998 pulmonary TB patients.
  • Screening for anti-Aspergillus antibodies at TB treatment initiation and 2 months.
  • Clinical assessment using chest x-ray, St. George's Respiratory Questionnaire (SGRQ), and 6-minute walking test.

Main Results:

  • Baseline Aspergillus seropositivity was 5.4%, associated with older age and prior TB history.
  • Aspergillus seropositivity independently predicted non-improvement in chest x-ray (aRR=1.76) and SGRQ score (aRR=1.44) at 2 months.
  • No significant association found between cavitary lesions and Aspergillus antibodies.

Conclusions:

  • Aspergillus seropositivity correlates with diminished clinical response during TB treatment.
  • This suggests aspergillosis may develop during TB treatment, necessitating vigilant monitoring.
  • Improved post-treatment surveillance is recommended to enhance long-term patient outcomes.
Keywords:
Anti-Aspergillus antibodyAspergillosisChronic pulmonary aspergillosisFungal infectionsPost-tuberculosis lung diseasePulmonary tuberculosisTB treatment

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