Can blood tests help predict if chronic pulmonary aspergillosis will come back?

This study from the National Aspergillosis Centre (NAC) looked at people with chronic pulmonary aspergillosis (CPA) who had completed antifungal treatment and asked a simple question:

Can blood tests tell us who is more likely to relapse after treatment stops?

What the researchers did

Doctors reviewed patients with CPA who had:

• Taken antifungal treatment for at least 6 months

• Stopped treatment because they were clinically stable

They then followed these patients to see who stayed well and who relapsed, and compared this with their blood test results at the time treatment stopped.

What they found

• About 1 in 4 patients had a relapse after stopping treatment

• People whose Aspergillus IgG blood test was still high at the end of treatment were much more likely to relapse

• Patients whose IgG level had fallen to a lower level did not relapse in this study

• Signs of Aspergillus allergy or sensitisation also increased relapse risk

• CT scan appearances and treatment length alone were not reliable predictors

Why this matters for patients

This means that:

• Blood tests may help doctors decide when it is safe to stop treatment

• Some people may need closer follow-up or longer treatment

• Follow-up can be more personalised, rather than “one size fits all”

Importantly, a relapse does not mean treatment failed — it reflects how persistent this infection can be in damaged lungs.

Key takeaway

A simple blood test at the end of treatment may help predict who needs closer monitoring for CPA relapse.

This research supports a more individualised approach to long-term CPA care.