Population prevalence of aspergillus sensitization and allergic bronchopulmonary aspergillosis in COPD subjects in North India

• Published in: Mycoses Vol. 67; no. 8; pp. e13784 - n/a
• Main Authors: Soundappan, Kathirvel, Muthu, Valliappan, Dhooria, Sahajal, Sehgal, Inderpaul Singh, Prasad, Kuruswamy Thurai, Rudramurthy, Shivaprakash Mandya, Chakrabarti, Arunaloke, Aggarwal, Ashutosh N., Agarwal, Ritesh
• Format: Journal Article
• Language: English
• Published: Germany Wiley Subscription Services, Inc 01.08.2024
• Subjects: abpm; Adult; Aged; Allergic bronchopulmonary aspergillosis; Antibodies, Fungal - blood; Aspergillosis; Aspergillosis, Allergic Bronchopulmonary - epidemiology; aspergillus fumigatus; Aspergillus fumigatus - immunology; bronchiectasis; Chronic obstructive pulmonary disease; COPD; Cross-Sectional Studies; Female; Humans; Immunoglobulin E; Immunoglobulin E - blood; Immunoglobulin G; India - epidemiology; Leukocytes (eosinophilic); Lung diseases; Male; Middle Aged; Prevalence; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - epidemiology; Respiratory function; Rural Population - statistics & numerical data; Urban Population - statistics & numerical data; India; aspergillus fumigatus; abpm; bronchiectasis; aspergillosis; COPD
• ISSN: 0933-7407; 1439-0507; 1439-0507
• DOI: 10.1111/myc.13784

Background Sensitization to Aspergillus fumigatus (AS) has been recently described in chronic obstructive pulmonary disease (COPD) patients. However, there is no data on the community prevalence of AS in COPD. Objectives To assess the prevalence of AS among COPD subjects. The secondary objectives were to (1) assess the prevalence of allergic bronchopulmonary aspergillosis (ABPA) in COPD and (2) compare the lung function in COPD subjects with and without AS. Methods We conducted a cross‐sectional study in rural (29 villages) and urban (20 wards) communities in North India. We identified individuals with respiratory symptoms (IRS) through a house‐to‐house survey using a modified IUATLD questionnaire. We then diagnosed COPD through specialist assessment and spirometry using the GOLD criteria. We assayed A.fumigatus‐specific IgE in COPD subjects. In those with A. fumigatus‐specific IgE ≥0.35 kUA/L (AS), ABPA was diagnosed with raised serum total IgE and raised A.fumigatus‐specific IgG or blood eosinophil count. Results We found 1315 (8.2%) IRS among 16,071 participants >40 years and diagnosed COPD in 355 (2.2%) subjects. 291 (82.0%) were men and 259 (73.0%) resided in rural areas. The prevalence of AS and ABPA was 17.7% (95% CI, 13.9–21.8) and 6.6% (95% CI, 4.4–8.8). We found a lower percentage predicted FEV1 in COPD subjects with AS than those without (p =.042). Conclusions We found an 18% community prevalence of AS in COPD subjects in a specific area in North India. Studies from different geographical areas are required to confirm our findings. The impact of AS and ABPA on COPD requires further research.