Infection and Drug Resistance (Apr 2022)

Metagenomic Next-Generation Sequencing for the Diagnosis of Suspected Opportunistic Infections in People Living with HIV

  • Xu J,
  • Huang Q,
  • Yu J,
  • Liu S,
  • Yang Z,
  • Wang F,
  • Shi Y,
  • Li E,
  • Li Z,
  • Xiao Y

Journal volume & issue
Vol. Volume 15
pp. 1767 – 1775

Abstract

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Jingying Xu, Qian Huang, Jianhua Yu, Shourong Liu, Zongxing Yang, Fei Wang, Yue Shi, Er Li, Zhaoyi Li, Yunlei Xiao Department of Infectious Diseases, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310023, People’s Republic of ChinaCorrespondence: Yunlei Xiao; Jingying Xu, Department of Infectious Diseases, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, No. 2, Hengbu Street, Liu Xia Town, Xihu District, Hangzhou, Zhejiang, 310023, People’s Republic of China, Tel +8615258639960 ; +8613588037550, Email [email protected]; [email protected]: The diagnosis of suspected opportunistic infections in HIV patients is challenging due to the wide range of potential causes. This study used mNGS to analyse specimens of suspected opportunistic infections in HIV patients from a single centre to explore this method’s applicability as a diagnostic tool compared to that of CMTs.Methods: We retrospectively investigated 46 suspected opportunistic infections in people living with HIV(PLWH) Hospitalized at Hangzhou Xixi hospital from January 2020 to August 2021. In total, we collected 49 samples (3 patients provided 2 samples) and sent them out for mNGS.Results: mNGS had a better detection rate for fungi and nontuberculous mycobacteria than that of CMTs. Specifically, the diagnostic detection rate of fungi (11 vs 19, P< 0.05) and nontuberculous mycobacteria (1 vs 6, p< 0.05) was significantly higher; there was no difference in detection rate for other pathogens (bacteria, Mycobacterium tuberculosis, or viruses). The sensitivity of mNGS was 90.91%, 50%, 0%, 100%, and 100% for detecting fungi, bacteria, Mycobacterium tuberculosis, nontuberculous mycobacteria, and viruses, respectively; the corresponding specificities were 74.29%, 97.73%, 86.36%, 86.67%, and 91.11%.Conclusion: mNGS technology provides an alternative and promising method of identifying suspected opportunistic infections in PLWH. Thus, the best diagnosis strategy may be using a combination of mNGS and CMTs.Keywords: metagenomic next-generation sequencing, infection, aetiological diagnosis, HIV, opportunistic infections

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