<![CDATA[Introduction: Chronic pulmonary aspergillosis (CPA) is a clinically important complication in patients with post-tuberculosis structural lung disease. Aspergillus-specific immunoglobulin G and spirometric parameters may help assess disease burden and treatment-associated change, but local data from Indonesia remain limited. This study evaluated changes in Aspergillus-specific IgG levels and lung function after itraconazole therapy in post-tuberculosis patients with probable CPA. Methods: This one-group pre-post study was conducted at the Pulmonology Outpatient Department of Dr. Saiful Anwar General Hospital, Malang, Indonesia, from July to December 2024. Post-tuberculosis patients were screened for probable CPA, and 16 patients who fulfilled the study criteria received oral itraconazole 200 mg twice daily for three months. Aspergillus-specific IgG was measured before and after therapy, and spirometric parameters including forced vital capacity, forced expiratory volume in one second, and FEV1/FVC were recorded. Aspergillus-specific IgG was analyzed using the Wilcoxon signed-rank test, while spirometric variables were analyzed using the paired t-test. Results: Twenty-nine post-tuberculosis patients were screened, and 16 fulfilled the criteria for probable CPA and completed the pre-post analysis. Aspergillus-specific IgG decreased from 1.01 ± 1.04 to 0.81 ± 0.94, but the change was not statistically significant (p=0.679). FEV1 increased significantly from 1.14 ± 0.51 L to 1.36 ± 0.69 L (p=0.04). Forced vital capacity increased from 1.95 ± 0.72 L to 2.10 ± 0.76 L (p=0.16), and FEV1/FVC increased from 59.78 ± 18.15 to 63.52 ± 16.23 (p=0.18), although both changes were not statistically significant. Conclusion: In post-tuberculosis patients with probable CPA, three months of itraconazole therapy was associated with a significant increase in FEV1, whereas Aspergillus-specific IgG, forced vital capacity, and FEV1/FVC did not change significantly. Larger controlled studies with longer follow-up are needed to clarify serological and functional response patterns.]]>
