Characteristics and risk factors for death in HIV-positive talaromycosis marneffei patients with sepsis
Mengyan Wang,
Xiaotian Dong,
Hu Wan,
Binhai Zhang,
Lele Yu,
Wenyan Yu,
Yan Zhang,
Kenv Pan,
Miaochan Wang,
Aifang Xu,
Yujiao Jin
Affiliations
Mengyan Wang
Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
Xiaotian Dong
Department of Clinical Laboratory, The First Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University, Zhejiang, 310003, China
Hu Wan
Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
Binhai Zhang
Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
Lele Yu
Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
Wenyan Yu
Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
Yan Zhang
Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
Kenv Pan
Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
Miaochan Wang
Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
Aifang Xu
Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
Yujiao Jin
Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China; Corresponding author. Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hengbu Street No. 2, Hangzhou, 310023, Zhejiang, China.
Objectives: This case-control study aimed to analyze the characteristics and risk factors for death in HIV-positive Talaromycosis marneffei (TSM) patients with sepsis. Methods: We retrospectively reviewed 173 AIDS patients diagnosed with TSM infection from January 1, 2013, to December 1, 2023, at Hangzhou Xixi Hospital. We collected and analyzed clinical characteristics, laboratory findings, bone marrow cytology results, treatment, and prognosis. Results: Out of 173 AIDS-TSM patients, 92 had sepsis while 81 did not. AIDS-TSM patients with sepsis have a higher in-hospital mortality rate (19.6 %) than non-sepsis patients (0 %). The SOFA score showed a significant association with in-hospital mortality in AIDS-TSM patients with sepsis (OR = 1.583, 95 % CI: 1.183–2.118, P = 0.002), indicating an almost linear relationship. After adjusting for the SOFA score, only hemoglobin (Hb) (OR = 0.971, 95 % CI: 0.943–1.000, P = 0.046), international normalized ratio (INR) (OR = 22.33, 95 % CI: 1.84–270.90, P = 0.015), and C-reactive protein (CRP) (OR = 1.014, 95 % CI: 1.001–1.027, P = 0.039) remained significantly associated with in-hospital mortality. The Receiver Operating Characteristic (ROC) curve of the SOFA score, INR, and CRP showed moderately good predictive performance for in-hospital mortality, while Hb had a low predictive performance. The Area Under Curve (AUC) values were 0.834, 0.820, 0.776, and 0.669, respectively. Conclusions: AIDS-TSM patients with sepsis have a higher mortality rate. Moreover, the SOFA score, along with Hb, INR, and CRP, are the risk factors for death in AIDS-TSM patients with sepsis.
