Serum triglyceride and high-density lipoprotein at admission are associated with 30-day overall mortality of patients with HIV and Talaromycosis.

Abstract

Objective: Dyslipidemia is common in severe infections, but its role in people with HIV and Talaromycosis (PWHT) remains unclear.

Design and method: Three hundred and eighty-seven PWHT were enrolled in present study. Furthermore, 267 of 387 PWHT, 267 people with HIV but without talaromycosis (PWH) and 267 healthy controls were selected to compare the lipid profiles by propensity score matching method on sex, age, body mass index, comorbidities and HBV infection.

Results: PWHT showed significantly lower total cholesterol [2.9(2.2-3.5) vs. 3.5(2.9-4.0) vs. 4.6(4.0-5.2) mmol/L, P < 0.001], LDL [1.5(0.9-2.0) vs. 1.9(1.5-2.4) vs. 2.5(2.1-3.1) mmol/L, P < 0.001] and HDL [0.5(0.3-0.7) vs. 0.7(0.6-0.9) vs. 1.2(1.0-1.4) mmol/L, P < 0.001], but higher triglycerides [1.6(1.2-2.0) vs. 1.3(1.0-1.7) vs.1.2(0.9-1.7)mmol/L, P < 0.001] than PWH and healthy controls at admission. Multivariate Cox analysis identified triglycerides ≥2.0 mmol/L [adjusted odds ratio (AOR)(95% confidential interval, CI):2.5(1.3-4.7), P = 0.005], HDL < 0.3 mmol/L [AOR:2.7(1.4-5.3), P = 0.004], age ≥35.0 years [AOR:3.2(1.6-6.4), P = 0.001], BMI < 18.0 kg/m2 [AOR:2.0(1.0-3.8), P = 0.036), WBC ≥5.0 × 109/L (AOR:2.4(1.3-4.6), P = 0.006), albumin <27 g/L (AOR:2.7(1.2-6.3), P = 0.018), and non-amphotericin B therapy (AOR:2.2(1.1-4.5), P = 0.028) as independent mortality risk factors. The 30-day overall mortality was higher in patients with triglycerides ≥2.0 mmol/L (24.0% vs. 7.6%, Log-rank P < 0.001) or HDL <0.3 mmol/L (27.1% vs. 6.5%, Log-rank P < 0.001) among PWHT.

Conclusion: PWHT exhibit distinct dyslipidemia patterns from PWH and healthy control. Elevated triglycerides and reduced HDL independently predicted poor outcomes of PWHT.