Timing of Antifungal Treatment and Prognostic Factors in Talaromyces marneffei Infection: A Retrospective Analysis of HIV-Positive Cases
摘要
Talaromyces marneffei (TM) infection is an emerging global threat that increasingly affects immunocompromised individuals, including those with HIV/AIDS. This study aims to systematically analyze the clinical characteristics and treatment regimens of TM infection in HIV-positive patients, with a focus on exploring the optimal timing for antifungal therapy.
DesignA retrospective cross-sectional analysis was performed on 96 HIV-positive patients with TM infection from the Fourth People’s Hospital of Nanning, Guangxi. The analysis included symptom manifestations, symptom combination patterns, laboratory test results, co-infection status, complications, and a comprehensive evaluation of treatment regimens, including medication types, combination strategies, and timing of administration.
ResultsThe study divided patients into three groups: rapid progression death group, stable progression death group, and survival group, to dissect the heterogeneity of the disease (the first two groups collectively constitute the Death Group, representing all deceased patients). Through statistical modeling and visual data exploration, a critical value of one month for medication timing was determined. Further multivariate analysis revealed that medication timing exceeding one month was identified as an independent risk factor for patient mortality. Renal impairment and serum albumin levels < 30 g/dL were identified as poor prognostic factors, while fever and hepatosplenomegaly were associated with a better prognosis, reflecting the body’s immune response capacity.
ConclusionsThe conclusions of this study provide empirical evidence for early empirical treatment of TM infection, explicitly defining the critical therapeutic time window as within 1 month of symptom onset. This information is crucial for improving patient outcomes and managing TM infection in immunocompromised populations.