Haiming Yan, Xinrui Gao, Suling Chen, Yuanhui Jiang, Jian Chen, Siyi Cen, Xuwen Xu, Jie Peng, Shaohang Cai
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引用次数: 0
Abstract
Talaromyces marneffei (T. marneffei) co-infection remains a significant cause of mortality in people living with HIV (PLWH). Although early detection of individuals at high risk is essential, there remains a lack of markers to predict outcomes. This multicenter retrospective study analyzed 282 PLWH (95 treatment-naïve T. marneffei co-infected, 187 without opportunistic infections) to evaluate six inflammatory indices: systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-platelet ratio (NPR), and pan-immune inflammation value (PIV). Multivariate logistic regression and ROC analysis were performed to identify risk factors and prognostic performance. The results revealed that T. marneffei group exhibited significantly elevated levels of SII, NPR, NLR, and PLR (P <0.001), with lower LMR (P <0.001) and PIV levels (P =0.014). Logistic regression identified thrombocytopenia (P =0.026), hypoalbuminemia (P =0.031), and lower CD4+ T-cell counts (P =0.011) as independent predictors of HIV-TM coinfection. Among the T. marneffei group, survivors (n=80) and non-survivors (n=15) exhibited distinct inflammatory profiles: NLR demonstrated optimal mortality prediction (AUC=0.788, P <0.001), outperforming NPR (AUC=0.671, P <0.001). Multivariate analysis confirmed NLR as the sole mortality predictor (P =0.041), with restricted cubic spline analysis indicating a non-linear NLR-mortality relationship. In conclusion, we found that NLR represents a reliable prognostic marker for PLWH co-infected with T. marneffei.
期刊介绍:
Medical Mycology is a peer-reviewed international journal that focuses on original and innovative basic and applied studies, as well as learned reviews on all aspects of medical, veterinary and environmental mycology as related to disease. The objective is to present the highest quality scientific reports from throughout the world on divergent topics. These topics include the phylogeny of fungal pathogens, epidemiology and public health mycology themes, new approaches in the diagnosis and treatment of mycoses including clinical trials and guidelines, pharmacology and antifungal susceptibilities, changes in taxonomy, description of new or unusual fungi associated with human or animal disease, immunology of fungal infections, vaccinology for prevention of fungal infections, pathogenesis and virulence, and the molecular biology of pathogenic fungi in vitro and in vivo, including genomics, transcriptomics, metabolomics, and proteomics. Case reports are no longer accepted. In addition, studies of natural products showing inhibitory activity against pathogenic fungi are not accepted without chemical characterization and identification of the compounds responsible for the inhibitory activity.