Risk of pulmonary aspergillosis in tuberculosis survivors: A nationwide population-based study

초록

Objective: To evaluate the long-term risk of pulmonary aspergillosis among tuberculosis (TB) survivors and identify risk factors associated with its development. Methods: Using data from Korea's Healthcare Big Data platform, which integrates information from the Korea National Health Insurance Service and the Korea Centers for Disease Control and Prevention, we conducted a retrospective cohort study including 13 653 TB survivors and 40 959 matched controls without a history of TB. Results: During a median follow-up of 5.4 years, the incidence of pulmonary aspergillosis was markedly higher among TB survivors than controls (0.89 vs. 0.09 per 1000 person-years; P < 0.001), corresponding to an adjusted hazard ratio (aHR) of 6.84 (95% confidence interval [CI], 3.89-12.1). Among TB survivors, low body mass index (aHR, 2.06; 95% CI, 1.11-3.82), diabetes mellitus (aHR, 4.45; 95% CI, 2.56-7.73), connective tissue disease (aHR, 23.19; 95% CI, 2.99-179.63), and bronchiectasis (aHR, 2.55; 95% CI, 1.08-6.04) were independently associated with pulmonary aspergillosis. Conclusions: TB survivors are at a substantially increased risk of pulmonary aspergillosis compared with individuals without a history of TB. Long-term surveillance and risk-based management strategies should be considered for this high-risk population. (c) 2026 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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