Original articles

Analysis of 133 dead cases of AIDS patients co-infected with Talaromycosis

Expand
  • Infectious Diseases Center, Guangzhou Eighth People′s Hospital, Guangzhou Medical University, Guangdong Guangzhou 510060, China

Received date: 2022-05-20

  Online published: 2022-11-07

Abstract

Objective: To investigate the mortality, clinical characteristics and related risk factors of death in the AIDS patient co-infected with Talaromycosis. Methods: A total of 133 AIDS patients co-infected with Talaromycosis who died from 2013 to 2021 in Guangzhou Eighth People′s Hospital of Guangzhou Medical University were enrolled and the information was analyzed retrospectively. The patients admitted in hospital were divided into two groups to compare the clinical data, which were 93 patients receiving antifungal therapy within 14 days after admission(Group A) and 40 patients died after 14 days (Group B). Results: From 2013 to 2021, a total of 18722 AIDS patients were admitted,and 1947 AIDS patients(10.4%) were co-infected with Talaromycosis. It revealed that 133 out of 1947 patients died, and the total mortality was 6.83%. The incidence of septic shock in Group A were significantly higher than those in Group B (93.5% vs 57.5%)(P<0.001). The blood bone marrow culture time, PTA, platelet count (<50×109/L), albumin level (20 g/L vs 25 g/L) and etiological conversion rate in Group A were lower than those in Group B (P<0.05). While the incidence of CMV, TB, PCP, severe pneumonia, and nosocomial infection rate in Group B were higher than those in Group A. Conclusions: The incidence and mortality of AIDS patients co-infected with Talaromycosis is high. The clinical symptoms of patient died early are septic shock, low platelet count and low albumin level, having a higher probability of early death and worse basic status. Most of the pathogens turne negative in the patients die later, while the other opportunistic infections or nosocomial infections could be important causes of death.

Cite this article

CHEN Zhimin, LIU Bo, He Haolan, HE Yaozu, FENG Lizhi, LIU Xinhua, ZHANG Jiansheng, CAI Weiping, LI Linghua . Analysis of 133 dead cases of AIDS patients co-infected with Talaromycosis[J]. Journal of Diagnostics Concepts & Practice, 2022 , 21(04) : 444 -449 . DOI: 10.16150/j.1671-2870.2022.04.005

References

[1] Granich R, Gupta S, Hersh B, et al. Trends in AIDS deaths, new infections and ART coverage in the top 30 countries with the highest AIDS mortality burden; 1990-2013[J]. PLoS One, 2015, 10(7):e0131353.
[2] 陈志敏, 何浩岚, 刘波, 等. 2013—2018年广州市某医院HIV感染住院患者全因病死率及死亡原因分析[J]. 国际病毒学杂志, 2021, 28(6):453-458.
[2] Chen ZM, He HL, Liu B, et al. Analysis on the all-cause mortality and causes of death among HIV-infected inpatients in a hosptial in Guangzhou, 2013-2018[J]. Int J Virol, 2021, 28(6):453-458.
[3] Larsson M, Nguyen LH, Wertheim HF, et al. Clinical characteristics and outcome of penicillium marneffei infection among HIV-infected patients in northern Vietnam[J]. AIDS Res Ther, 2012, 9(1):24.
[4] 何小庆, 鲁雁秋, 周怡宏, 等. 重庆地区56例AIDS合并播散性马尔尼菲篮状菌病患者临床特征及死亡危险因素分析[J]. 传染病信息, 2018, 31(6):521-524.
[4] He XQ, Lu YQ, Zhou YH, et al. Clinical characteristics and death risk factors analysis of 56 AIDS patients with disseminated talaromycosis marneffei in Chongqing[J]. Infectious Disease Information, 2018, 31(6):521-524.
[5] 中华医学会感染病学分会艾滋病丙型肝炎学组, 中国疾病预防控制中心. 中国艾滋病诊疗指南(2021年版)[J]. 中华内科杂志, 2021, 60(12):1106-1128.
[5] AIDS and hepatitis C study group, infectious disease branch, Chinese Medical Association, Chinese Center for Disease Control and Prevention. Chinese guidelines for diagnosis and treatment of HIV/AIDS (2021 edition)[J]. Chin J Intern Med, 2021, 60(12):1106-1128.
[6] 李凌华, 唐小平, 蔡卫平. 101例艾滋病合并马尔尼菲青霉病的临床研究[J]. 中国艾滋病性病, 2008, 14(1):12-14,20.
[6] Li LH, Tang XP, Cai WP. A clinical study on 101 AIDS cases complicated with penicilliosis marneffei[J]. Chin J AIDS & STD, 2008, 14(1):12-14,20.
[7] 陈涛, 蒋忠胜, 李敏基, 等. CD4+T淋巴细胞、血清转氨酶及血小板水平对马尔尼菲蓝状菌病患者预后的预测价值[J]. 中国感染控制杂志, 2018, 17(12):1098-1102.
[7] Chen T, Jiang ZS, Li MJ, et al. Predictive value of CD4+ T lymphocyte, serum aminotransferase, and platelet in the prognosis of patients with talaromycosis marneffeii[J]. Chin J Infect Control, 2018, 17(12):1098-1102.
[8] Qin Y, Zhou Y, Lu Y, et al. Multicentre derivation and validation of a prognostic scoring system for mortality assessment in HIV-infected patients with talaromycosis[J]. Mycoses, 2021, 64(2):203-211.
[9] 何凯茵, 冯理智, 梁志伟, 等. 血清半乳甘露聚糖试验在诊断艾滋病合并马尔尼菲青霉菌病中的价值探讨[J]. 广州医科大学学报, 2016, 44(3):21-24.
[9] He KY, Feng LZ, Liang ZW, et al. Value of serum galactomannan test in diagnosis of AIDS complicated with penicilliosis marneffei[J]. Acad J Guangzhou Med Coll, 2016, 44(3):21-24.
[10] 梁欣, 马卫国, 黎灿, 等. APACHEⅡ/Ⅲ与SAPSⅡ评分系统对艾滋病合并播散性马尔尼菲青霉菌病患者病情预后评估的价值[J]. 中国实用医药, 2012, 7(27):12-14.
[10] Liang X, Ma WG, Li C, et al. Comparison of APACHEⅡ/Ⅲ and SAPSⅡ in evaluating the severity and prognosis of patients with disseminated penicilliosis marneffei associated AIDS[J]. China Pract Med, 2012, 7(27):12-14.
[11] Le T, Kinh NV, Cuc NTK, et al. A trial of itraconazole or amphotericin B for HIV-associated talaromycosis[J}. N Engl J Med, 2017, 376(24):2329-2340.
[12] 袁锡华, 曹存巍. 伏立康唑与两性霉素B治疗AIDS合并马尔尼菲蓝状菌病的疗效及安全性对比[J]. 广西医科大学学报, 2019, 36(2):262-265.
[12] Yuan XH, Cao CW. Comparison of efficacy and safety of voriconazole and amphotericin B in the treatment of AIDS combined with talaromycosis marneffei[J]. J Guangxi Med Univ, 2019, 36(2):262-265.
[13] Sun J, Sun W, Tang Y, et al. Clinical characteristics and risk factors for poor prognosis among HIV patients with Talaromyces marneffei bloodstream infection[J]. BMC Infect Dis, 2021, 21(1):514.
[14] Ying RS, Le T, Cai WP, et al. Clinical epidemiology and outcome of HIV-associated talaromycosis in Guangdong, China, during 2011-2017[J]. HIV Med, 2020, 21(11):729-738.
[15] 黄丽芬, 邓子德, 叶晓新, 等. 345例艾滋病死亡病例的医院感染状况分析[J]. 中国感染控制杂志, 2013, 12(3):178-181.
[15] Huang LF, Deng ZD, Ye XX, et al. Healthcare-associated infection in 345 HIV/AIDS death cases[J]. Chin J Infect Control, 2013, 12(3):178-181.
Outlines

/