Diagnostic performance of Aspergillus-specific immunoglobulin G immunochromatographic and enzyme-linked immunosorbent assay testing in chronic pulmonary aspergillosis: comparative analysis across subtypes and influencing factors

Background: -specific IgG testing, comparing rapid immunochromatographic point-of-care test (ICT-POCT) with enzyme-linked immunosorbent assay (ELISA) for CPA and its subtypes, while identifying factors influencing test accuracy. Methods: galactomannan (GM) was tested where available. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results: nodule(s) (AN). In addition, the sensitivity of the ICT assay differed in comorbidities: 76.5% in patients with chronic obstructive pulmonary disease (COPD), 97.3% in patients with bronchiectasis, and 96.7% in patients with cavitary pulmonary tuberculosis. Notably, prior antifungal and steroid therapy decreased the performance of both assays. Conclusions: -specific IgG ICT assay shows significant diagnostic value for CPA, particularly in untreated patients and CCPA subtype. Its high specificity and rapid format position it as a valuable point-of-care tool for prompt CPA diagnosis in resource-limited settings.