Effects of Talaromyces marneffei infection on mortality of HIV/AIDS patients in southern China: a retrospective cohort study

Jiang, Junjun; Meng, Sirun; Huang, Shenghong; Ruan, Yuhua; Lu, Xiaoyan; Li, Jonathan Z.; Wu, Nianning; Huang, Jiegang; Xie, Zhiman; Liang, Bingyu; Deng, Jianning; Zhou, Bo; Chen, Xiaoyu; Ning, Chuanyi; Liao, Yulin; Wei, Wudi; Lai, Jingzhen; Li, Ye; Wu, Fengyao; Liang, Hao

doi:10.1016/j.cmi.2018.04.018

Cited by 116 publications

(119 citation statements)

References 28 publications

(24 reference statements)

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“…A large-scale retrospective cohort study was conducted in the Fourth People's Hospital of Nanning (Guangxi, China) as we reported previously [15]. The Fourth People's Hospital of Nanning (Guangxi, China) is a designated hospital for AIDS treatment in Guangxi.…”

Section: Study Patients and Data Collectionmentioning

confidence: 99%

“…These measures may lead to improved survival in the short stay during hospitalisation. In this study, the average The management of HIV-infected inpatients in Guangxi is still a challenge for local AIDS prevention and control [15]. We expect our exploration to provide an innovative strategy to identify hospitalised PLWHAs at high risk of early death for HIV care and timely interventions in the clinic.…”

Section: Epidemiology and Infectionmentioning

confidence: 99%

“…HIV/ AIDS patients in Guangxi more often suffer from various comorbidities and have much higher mortality than the national average level [13,14]. For example, in Guangxi, approximately 16.1% of hospitalised HIV-infected patients were coinfected with Talaromyces marneffei, which is rarely found in most other areas of China and accounts for 17.5% of all deaths among HIV-infected inpatients in Guangxi [15].…”

Section: Introductionmentioning

confidence: 99%

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Development and external-validation of a nomogram for predicting the survival of hospitalised HIV/AIDS patients based on a large study cohort in western China

et al. 2020

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The aim of this study was to develop and externally validate a simple-to-use nomogram for predicting the survival of hospitalised human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients (hospitalised person living with HIV/AIDS (PLWHAs)). Hospitalised PLWHAs (n = 3724) between January 2012 and December 2014 were enrolled in the training cohort. HIV-infected inpatients (n = 1987) admitted in 2015 were included as the external-validation cohort. The least absolute shrinkage and selection operator method was used to perform data dimension reduction and select the optimal predictors. The nomogram incorporated 11 independent predictors, including occupation, antiretroviral therapy, pneumonia, tuberculosis, Talaromyces marneffei, hypertension, septicemia, anaemia, respiratory failure, hypoproteinemia and electrolyte disturbances. The Likelihood χ2 statistic of the model was 516.30 (P = 0.000). Integrated Brier Score was 0.076 and Brier scores of the nomogram at the 10-day and 20-day time points were 0.046 and 0.071, respectively. The area under the curves for receiver operating characteristic were 0.819 and 0.828, and precision-recall curves were 0.242 and 0.378 at two time points. Calibration plots and decision curve analysis in the two sets showed good performance and a high net benefit of nomogram. In conclusion, the nomogram developed in the current study has relatively high calibration and is clinically useful. It provides a convenient and useful tool for timely clinical decision-making and the risk management of hospitalised PLWHAs.

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Section: Study Patients and Data Collectionmentioning

confidence: 99%

Section: Epidemiology and Infectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development and external-validation of a nomogram for predicting the survival of hospitalised HIV/AIDS patients based on a large study cohort in western China

et al. 2020

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“…2,6 In a retrospective cohort study of patients with HIV/ AIDS in southern China, mortality was significantly greater in patients with T. marneffei than in those without, with an inhospital mortality rate of 17.5% and 7.6%, respectively. 7 Common laboratory findings in disseminated T. marneffei infection include elevated liver enzyme levels, anemia and thrombocytopenia. 2,6…”

Section: Disseminated Talaromyces Marneffei Infectionmentioning

confidence: 99%

Talaromyces marneffei fungemia after travel to China in a Canadian patient with AIDS

Waters

Beliavsky

Gough

2020

CMAJ

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“…The proportion of HIV patients infected with T. marneffei is ~ 10% in China currently [3,6] , and approximately 99% of T. marneffei infections were reported from the southern regions, of which 43% were from Guangxi [6] . Thus, infection with T. marneffei is common among HIV/ AIDS patients in Guangxi, ranking fourth among all AIDS-related complications with a 16.1% prevalence [8] .…”

Section: Introductionmentioning

confidence: 99%

Predictive models for Talaromyces marneffei infection in HIV-infected patients using routinely collected data

Hu¹,

Li²,

Chen³

et al. 2020

Preprint

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ObjectivesLate diagnosis of Talaromyces marneffei (T. marneffei) in patients with HIV/AIDS infection is strongly associated with greater mortality. To date, effective predictive model for T. marneffei infection in clinical practice have not been established. We aimed to identify a non-culture-based method for rapid detection of T. marneffei infection in HIV/AIDS patients.MethodsThe prediction models were initially constructed using patients in a retrospective cohort study. We obtained demographics, clinical and laboratory data for each individual. Univariate comparisons, logistic regression, Random Forest (RF) analysis and receiver-operating characteristic curves (ROC) were used to identify and evaluate the predictive factors of T. marneffei infection status.ResultsHIV-infected patients with a baseline characterized by weight loss, typical skin lesions, peripheral or abdominal lymphadenopathy (POAL), hepatomegaly, splenomegaly, decrease lymphocyte count, abnormal aspartate aminotransferase (AST) level , higher AST to alanine aminotransferase (ALT) ratio index (AARI) level (>1) and lower (<50 cells/mL) CD4+ T-cell counts had an increased risk of T. marneffei infection. Skin lesions, POAL, AARI, AST level and CD4+ T-cell count resulted in good classifiers of T. marneffei infection by RF analysis. RF model had a relative high power [area under the ROC curve (AUC): 0.859] to predict T. marneffei infection in the present study. A new indicator combine AST level and AARI could increase the classification power of the model (AUC: 0.877).ConclusionOur data suggest that accurate assessments for T. marneffei infection can be obtained using routinely collected data of patients with HIV. The prediction model could used to identify HIV patients who currently have early stage of T. marneffei infection, which would be benefit to both patients and clinicians.

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Effects of Talaromyces marneffei infection on mortality of HIV/AIDS patients in southern China: a retrospective cohort study

Cited by 116 publications

References 28 publications

Development and external-validation of a nomogram for predicting the survival of hospitalised HIV/AIDS patients based on a large study cohort in western China

Development and external-validation of a nomogram for predicting the survival of hospitalised HIV/AIDS patients based on a large study cohort in western China

Talaromyces marneffei fungemia after travel to China in a Canadian patient with AIDS

Predictive models for Talaromyces marneffei infection in HIV-infected patients using routinely collected data

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