Characteristics and outcomes of chronic pulmonary aspergillosis: a retrospective analysis of a tertiary hospital registry Boubou Camara 1,2 , Emilie Reymond 2,6 , Christel Saint-Raymond 1,2 , Hubert Roth 1,2,7,8 , Marie-Pierre Brenier-Pinchart 2,3 , Claudine Pinel 2,3 , Jacques Cadranel 4,5 , Gilbert Ferretti 2,6 , Hervé Pelloux 2,3 , Christophe Pison 1,2,8 and Grenoble Aspergillus Committee* 1 Clinique Universitaire de Pneumologie, CHU Grenoble, Grenoble, France 2 Université Joseph Fourier, Grenoble, France 3 Laboratoire de Parasitologie-Mycologie, CHU Grenoble, Grenoble, France 4 Service de Pneumologie et Réanimation, Hôpital Tenon, Paris, France 5 Faculté de Médecine Pierre-et-Marie-Curie, Université Paris VI, Paris, France 6 Clinique d’Imagerie Médicale, CHU Grenoble, Grenoble, France 7 CRNH Rhône-Alpes, Pierre-Bénite, France 8 Inserm1055, Grenoble, France Abstract Introduction: Our objective was to investigate characteristics risk factors and out- comes of patients with chronic pulmonary aspergillosis (CPA). Methods: The Aspergillosis Committee prospectively collected Aspergillus notifi- cations from January 2000 to December 2011. A retrospective analysis of data was performed. Results: Among 1614 notifications registered, 44 cases of CPA in non- immunocompromised patients were identified. The median age was 65 years (Q1–Q3: 54–75), the median body mass index (BMI) was 20 kg/m 2 (Q1–Q3: 16–22) and 15 had chronic obstructive pulmonary disease. All patients had a positive specific serum precipitin antibody titer. Radiological presentations were: cavitations [single n = 31 (70%); multiple n = 12 (27%)] containing mycetomas [n = 18 (41%)], consolidations [n = 19 (43%)], emphysema [n = 15 (34%)] and sequelae of mycobacterial infection [n = 10 (23%)]. The median duration of follow-up was 30 months (Q1–Q3: 14–55). The median duration of antifungal treatment was 6 months (Q1–Q3: 3–12). Outcomes were unfavorable in 14 patients, and 12 (27%) died. Analysis by multivariate Cox regression model with bootstrapping showed that a higher BMI and a lower Charlson index score were predictive of favorable evolution, hazard ratio (95% confidence interval): BMI (+1) = 0.83 (0.71–0.97), Charlson (+1) = 1.37 (1.01–1.85). When analyses were restricted to chronic CPA and chronic necrotizing pulmonary aspergillosis, the multivariate Cox regression model showed that both BMI and Charlson index score were not statistically significant. Conclusion: Our results provide data on clinical characteristics and outcomes of CPA emphasizing the role of preexisting chronic respiratory conditions and pro- tective effect of preserved BMI and lower Charlson index score. Please cite this paper as: Camara B, Reymond E, Saint-Raymond C, Roth H, Brenier-Pinchart M-P, Pinel C, Cadranel J, Ferretti G, Pelloux H, Pison C and Grenoble Aspergillus Committee. Characteristics and outcomes of chronic pulmo- nary aspergillosis: a retrospective analysis of a tertiary hospital registry. Clin Respir J 2015; 9: 65–73. Key words Aspergillus – BMI – chronic pulmonary aspergillosis – COPD Correspondence Boubou Camara, MD, Clinique Universitaire de Pneumologie, Hôpital Albert Michallon, CHU de Grenoble, CS10217, 38043 Grenoble Cedex 9, France. Tel: +33 4 76 76 58 46 Fax: +33 4 76 76 87 32 email: bcamara@chu-grenoble.fr Received: 22 April 2013 Revision requested: 03 December 2013 Accepted: 04 January 2014 DOI:10.1111/crj.12105 *Aspergillus Commitee of Grenoble University Hospital: B. Camara, S. Quetant, B. Lebeau, A. Thiebaut-Bertrand, C. Saint-Raymond, D. Maubon, A. Bosseray, R. Hamidfar, C. Pinel, H. Pelloux, M. P. Brenier-Pinchart, M. R. Mallaret, D. Plantaz, S. Goutier, M. Cornet, O. Epaulard, E. Reymond and G. Ferretti. Authorship and contributorship Conception and design: B. Camara, H. Roth, J. Cadranel and C. Pison; data collection for the article: B. Camara, E. Reymond, C. Saint-Raymond, M. P. Brenier-Pinchart, C. Pinel, G. Ferretti, H. Pelloux and Grenoble Aspergillus Committee; literature search: B. Camara, H. Roth, M. P. Brenier-Pinchart and C. Pison; analysis and interpretation of data: B. Camara, E. Reymond, H. Roth, M. P. Brenier-Pinchart, G. Ferretti and C. Pison; The Clinical Respiratory Journal ORIGINAL ARTICLE 65 The Clinical Respiratory Journal (2015) • ISSN 1752-6981 © 2014 John Wiley & Sons Ltd