J Jiang1, S Meng2, S Huang3, Y Ruan4, X Lu3, J Z Li5, N Wu3, J Huang1, Z Xie3, B Liang1, J Deng3, B Zhou6, X Chen3, C Ning6, Y Liao6, W Wei1, J Lai1, L Ye7, F Wu8, H Liang9. 1. Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China. 2. Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China; Fourth People's Hospital of Nanning, Nanning, Guangxi, China. 3. Fourth People's Hospital of Nanning, Nanning, Guangxi, China. 4. State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, Chinese Centre for Disease Control and Prevention (China CDC), Beijing, China. 5. Brigham and Women's Hospital, Harvard Medical School, Cambridge, MA, USA. 6. Guangxi Collaborative Innovation Centre for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China. 7. Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China. Electronic address: yeli@gxmu.edu.cn. 8. Fourth People's Hospital of Nanning, Nanning, Guangxi, China. Electronic address: wufengyao@126.com. 9. Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Collaborative Innovation Centre for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China. Electronic address: lianghao@gxmu.edu.cn.
Abstract
OBJECTIVE: Talaromyces marneffei is an opportunistic infection with high morbidity among human immunodeficiency virus (HIV)/AIDS patients in Southeast Asia and southern China. Its effects on mortality in HIV/AIDS patients has not been clearly elucidated. METHODS: We conducted a retrospective cohort study of hospitalized HIV-infected individuals at the Fourth People's Hospital of Nanning, Guangxi, China during 2012-2015. Kaplan-Meier analyses were used to calculate the cumulative mortality. Cox proportional hazard models and 1:1 propensity score matching (PSM) were used to evaluate the effects of T. marneffei infection on mortality of HIV/AIDS patients. RESULTS: In total, 6791 HIV/AIDS patients were included, 1093 of them (16.1%) with documented T. marneffei co-infection. The mortality of T. marneffei-infected patients (25.0 per 100 person-months, 95% CI 21.5-26.7) was the highest among all AIDS-associated complications and was significantly higher than that of T. marneffei-uninfected HIV/AIDS patients (13.8 per 100 person-months, 95% CI 12.5-15.1; adjusted hazard ratio (AHR) 1.80, 95% CI 1.48-2.16). The results using PSM were similar (AHR 4.52 95% CI 2.43-8.42). The mortality of T. marneffei-infected patients was also significantly higher than that of patients without any complications. When stratified by demographic characteristics, T. marneffei infection has higher mortality risk in all stratifications. Co-infection with T. marneffei carries a higher mortality risk in patients at any CD4+ T-cell count. CONCLUSIONS: Talaromyces marneffei infection is commonly found in hospitalized HIV/AIDS patients in southern China and was associated with a higher mortality rate than most HIV-associated complications. These results highlight the need for improved diagnosis, treatment and prevention of infection by this neglected fungal pathogen in southern China.
OBJECTIVE:Talaromyces marneffei is an opportunistic infection with high morbidity among human immunodeficiency virus (HIV)/AIDSpatients in Southeast Asia and southern China. Its effects on mortality in HIV/AIDSpatients has not been clearly elucidated. METHODS: We conducted a retrospective cohort study of hospitalized HIV-infected individuals at the Fourth People's Hospital of Nanning, Guangxi, China during 2012-2015. Kaplan-Meier analyses were used to calculate the cumulative mortality. Cox proportional hazard models and 1:1 propensity score matching (PSM) were used to evaluate the effects of T. marneffei infection on mortality of HIV/AIDSpatients. RESULTS: In total, 6791 HIV/AIDSpatients were included, 1093 of them (16.1%) with documented T. marneffei co-infection. The mortality of T. marneffei-infectedpatients (25.0 per 100 person-months, 95% CI 21.5-26.7) was the highest among all AIDS-associated complications and was significantly higher than that of T. marneffei-uninfected HIV/AIDSpatients (13.8 per 100 person-months, 95% CI 12.5-15.1; adjusted hazard ratio (AHR) 1.80, 95% CI 1.48-2.16). The results using PSM were similar (AHR 4.52 95% CI 2.43-8.42). The mortality of T. marneffei-infectedpatients was also significantly higher than that of patients without any complications. When stratified by demographic characteristics, T. marneffei infection has higher mortality risk in all stratifications. Co-infection with T. marneffei carries a higher mortality risk in patients at any CD4+ T-cell count. CONCLUSIONS:Talaromyces marneffei infection is commonly found in hospitalized HIV/AIDSpatients in southern China and was associated with a higher mortality rate than most HIV-associated complications. These results highlight the need for improved diagnosis, treatment and prevention of infection by this neglected fungal pathogen in southern China.
Authors: R S Ying; T Le; W P Cai; Y R Li; C B Luo; Y Cao; C Y Wen; S G Wang; X Ou; W S Chen; S Z Chen; P L Guo; M Chen; Y Guo; X P Tang; L H Li Journal: HIV Med Date: 2020-12 Impact factor: 3.180
Authors: George R Thompson; Thuy Le; Ariya Chindamporn; Carol A Kauffman; Ana Alastruey-Izquierdo; Neil M Ampel; David R Andes; Darius Armstrong-James; Olusola Ayanlowo; John W Baddley; Bridget M Barker; Leila Lopes Bezerra; Maria J Buitrago; Leili Chamani-Tabriz; Jasper F W Chan; Methee Chayakulkeeree; Oliver A Cornely; Cao Cunwei; Jean-Pierre Gangneux; Nelesh P Govender; Ferry Hagen; Mohammad T Hedayati; Tobias M Hohl; Grégory Jouvion; Chris Kenyon; Christopher C Kibbler; Nikolai Klimko; David C M Kong; Robert Krause; Low Lee Lee; Graeme Meintjes; Marisa H Miceli; Peter-Michael Rath; Andrej Spec; Flavio Queiroz-Telles; Ebrahim Variava; Paul E Verweij; Ilan S Schwartz; Alessandro C Pasqualotto Journal: Lancet Infect Dis Date: 2021-08-06 Impact factor: 71.421