Clinical Characteristics and Prognosis of AIDS Complicated with Talaromycosis marneffei Infection: a Single-Center Retrospective Study.

Abstract

Introduction: The objective of the study was to determine the clinical features and prognostic risk factors of acquired immunodeficiency syndrome (AIDS) combined with Talaromyces marneffei (TM) infection.

Methods: We retrospectively analyzed the clinical data of 133 hospitalized patients diagnosed with AIDS and TM co-infection. Patients were divided into an improvement group and a deterioration group on the basis of their discharge outcomes. To further investigate the severity of adverse outcomes, subgroup analysis was performed on the deterioration group. Due to the issue of complete separation in the data, Firth's logistic regression model was employed to identify independent prognostic factors. Finally, the predictive performance of the model was evaluated using the receiver operating characteristic (ROC) curve.

Results: Among 133 patients with AIDS and TM co-infection, the main manifestations were fever (93.23%) and severe immunodeficiency with median CD4⁺ T cell count of 8.50 cells/μL, with blood culture showing the highest positive rate (93.85%). Firth's logistic regression analysis revealed that timely antifungal therapy (OR 0.004, 95% CI <0.001-0.047, P < 0.001) and higher baseline albumin (ALB) levels (OR 0.858, 95% CI 0.732-0.973, P = 0.016) were independent protective factors for improving patient prognosis. The area under the receiver operating characteristic (ROC) curve (AUC) of the model was 0.930 (95% CI 0.878-0.982).

Conclusions: Timely antifungal therapy and good nutritional status are key determinants of prognosis in patients with AIDS and TM co-infection. Early diagnosis, prompt initiation of effective treatment, and active nutritional support are of great significance for improving patient survival outcomes.