Prevalence and clinical correlates of chronic pulmonary aspergillosis among symptomatic post-tuberculosis patients at a tertiary hospital in Eastern India

Chronic pulmonary aspergillosis (CPA) is an underrecognized but significant sequela of pulmonary tuberculosis (TB), and data from India remain limited. In this single-center, cross-sectional study from eastern India, we evaluated 280 post-TB patients with residual radiological abnormalities to estimate CPA prevalence and identify associated clinical, radiological, and biochemical features. After excluding patients with active TB, interstitial lung disease, malignancy, or prior antifungal therapy, all participants underwent clinical assessment, spirometry, high-resolution computed tomography, Aspergillus-specific serology, and bronchoalveolar lavage when indicated. CPA was diagnosed in 27.5% of patients, with chronic cavitary pulmonary aspergillosis being the most common subtype. Multivariable analysis showed that low body mass index, the presence of aspergilloma, and elevated C-reactive protein were independently associated with CPA, while Aspergillus-specific IgG was positive in 92.2% of cases. These findings highlight the high burden of CPA among post-TB patients in India and underscore the need for greater clinician awareness and standardized screening to ensure timely diagnosis and management.