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J Infect. 2016 Feb;72(2):240-9. doi: 10.1016/j.jinf.2015.11.003. Epub 2015 Dec 8.

Comparison of six Aspergillus-specific IgG assays for the diagnosis of chronic pulmonary aspergillosis (CPA).

Author information

1
The University of Manchester, Oxford Road, Manchester M13 9PL, UK; Manchester Academic Health Science Centre, 46 Grafton Street, Manchester M13 9NT, UK; National Aspergillosis Centre, 2nd Floor Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK. Electronic address: iain.page@pat.nhs.uk.
2
The University of Manchester, Oxford Road, Manchester M13 9PL, UK; Manchester Academic Health Science Centre, 46 Grafton Street, Manchester M13 9NT, UK; Mycology Reference Centre, Manchester and National Aspergillosis Centre, 2nd Floor Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK. Electronic address: malcolm.ricahrdson@manchester.ac.uk.
3
The University of Manchester, Oxford Road, Manchester M13 9PL, UK; Manchester Academic Health Science Centre, 46 Grafton Street, Manchester M13 9NT, UK; National Aspergillosis Centre, 2nd Floor Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK. Electronic address: ddenning@manchester.ac.uk.

Abstract

OBJECTIVES:

Chronic pulmonary aspergillosis (CPA) is estimated to affect 3 million persons worldwide. Aspergillus-specific IgG is a key component in CPA diagnosis. We aimed to establish the optimal diagnostic cut offs for CPA and the comparative performance of six assays in this context.

METHODS:

Sera from 241 patients with CPA and 100 healthy blood donors were tested using five Aspergillus-specific IgG assays plus precipitin testing using Microgen Aspergillus antigens.

RESULTS:

Receiver operating characteristic (ROC) curve area under the curve (AUC) results were as follows: ThermoFisher Scientific ImmunoCAP 0.996 (95% confidence interval 0.992-1), Siemens Immulite 0.991 (0.982-1), Serion 0.973 (0.960-0.987), Dynamiker 0.918 (0.89-0.946) and Genesis 0.902 (0.871-0.933). Optimal CPA diagnostic cut-offs were; ImmunoCAP 20 mg/L (96% sensitivity, 98% specificity), Immulite 10 mg/L (96% sensitivity, 98% specificity), Serion 35 U/ml (90% sensitivity, 98% specificity), Dynamiker 65 AU/ml (77% sensitivity, 97% specificity) and Genesis 20 U/ml (75% sensitivity, 99% specificity). The precipitin test was 59% sensitive and 100% specific.

CONCLUSIONS:

ImmunoCAP and Immulite were statistically significantly superior to the other assays. Precipitins testing performed poorly. The currently accepted ImmunoCAP cut-off of 40 mg/L appears sub-optimal for CPA diagnosis and may require revision in this context.

KEYWORDS:

Antigen; Aspergilloma; Aspergillosis; Aspergillus fumigatus; CPA; ELISA

PMID:
26680697
DOI:
10.1016/j.jinf.2015.11.003
[Indexed for MEDLINE]

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