EPS02.6 Rising prevalence of allergic bronchopulmonary aspergillosis (ABPA) in CF – an unforeseen result of climate change?

Abstract

Objectives Aspergillus-related lung disease is an important complication of pulmonary disease in CF patients, leading to worsening symptomatology and lung function and we had the clinical impression that its incidence is increasing. Although ABPA is quoted at 5–15%, we wished to identify the true rate of Aspergillus sensitivity in our adult CF population and assess how this may have changed over time. Methods We measured Aspergillus specific IgG in 282 adult CF patients, identifying those with values above the normal range (40 mg/ml) and compared these to our previous study in 202 patients reported in 2009. We also identified patients with a clinical diagnosis of ABPA and compared this to the quoted prevalence in the wider CF population. Results 152 patients (54%, mean age 27 years [range 18–69], 89 male) had a raised specific IgG level, compared to 84 (42%, 29 years [20–52], 45 male) in 2009. Currently, 48 [32%; 26 male, 29 years, (18–57 years), 17% of our total CF cohort] have a diagnosis of ABPA, higher than the quoted prevalence. Conclusion We are seeing an increasing proportion of CF patients with raised immunological markers to Aspergillus with time. This suggests increased exposure to Aspergillus , perhaps as a result of the wetter climate produced in the UK by climate change and in turn indicates that ABPA is and will be a more frequently occurring complication in CF patients.