{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:36:09Z","timestamp":1784122569284,"version":"3.55.0"},"reference-count":8,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of the study was to determine whether it is safe to stop secondary prophylaxis in patients with talaromycosis after immune reconstitution with a sustained increase in CD4 count to \u2265 100 cells\/\u00b5L after antiretroviral therapy (ART).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort analysis was performed in HIV\u2010infected patients treated for talaromycosis between June 2009 and June 2017 in Medical Action Myanmar (MAM) clinics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among a cohort of 5466 HIV\u2010infected patients, 41 patients were diagnosed with and treated for clinical talaromycosis. All the patients were on ART and had a CD4 count &lt;\u00a0100\u00a0cells\/\u00b5L. Of these 41 patients, 24 patients (71%) were skin smear positive for talaromycosis, while results were negative in 17 patients. Median CD4 count and haemoglobin concentration were 24 cells\/\u00b5L and 7.7\u00a0g\/dL, respectively. Seventy\u2010three per cent (30) were male. Among the 41 patients, 11 (27%) died and six (15%) were transferred to other centres. Twenty\u2010four patients (58% of the total diagnosed) stopped itraconazole secondary prophylaxis after starting active ART with CD4 counts &gt; 100 cells\/\u00b5L for at least 1\u00a0year. Throughout the duration of follow\u2010up post itraconazole cessation, the observed incidence of relapse was zero with a total follow\u2010up of 93.8 person\u2010years (95% confidence interval 0\u20134 per 100 person\u2010years). The median (25th, 75th percentile) duration of follow\u2010up post\u2010prophylaxis discontinuation was 2.8 (2.1, 6.3) years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Secondary prophylaxis can be safely stopped in patients with talaromycosis after immune reconstitution with a sustained increase in CD4 count to \u2265 100 cells\/\u00b5L after highly active antiretroviral therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12921","type":"journal-article","created":{"date-parts":[[2020,8,2]],"date-time":"2020-08-02T04:04:35Z","timestamp":1596341075000},"page":"671-673","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Is stopping secondary prophylaxis safe in HIV\u2010positive talaromycosis patients? Experience from Myanmar"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1496-7813","authenticated-orcid":false,"given":"N","family":"Tun","sequence":"first","affiliation":[{"name":"Medical Action Myanmar Yangon Myanmar"},{"name":"Myanmar Oxford Clinical Research Unit Yangon Myanmar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Mclean","sequence":"additional","affiliation":[{"name":"Medical Action Myanmar Yangon Myanmar"},{"name":"Myanmar Oxford Clinical Research Unit Yangon Myanmar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X","family":"Deed","sequence":"additional","affiliation":[{"name":"Medical Action Myanmar Yangon Myanmar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Hlaing","sequence":"additional","affiliation":[{"name":"Medical Action Myanmar Yangon Myanmar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Aung","sequence":"additional","affiliation":[{"name":"Medical Action Myanmar Yangon Myanmar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Wilkins","sequence":"additional","affiliation":[{"name":"North Manchester, Infectious Diseases Crumpsall Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Ashley","sequence":"additional","affiliation":[{"name":"Myanmar Oxford Clinical Research Unit Yangon Myanmar"},{"name":"Centre for Tropical Medicine and Global Health Oxford Oxford University Oxfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Smithuis","sequence":"additional","affiliation":[{"name":"Medical Action Myanmar Yangon Myanmar"},{"name":"Myanmar Oxford Clinical Research Unit Yangon Myanmar"},{"name":"Centre for Tropical Medicine and Global Health Oxford Oxford University Oxfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8]]},"reference":[{"key":"e_1_2_4_2_1","unstructured":"SupparatpinyoK KhamwanC BaosoungVet al.DisseminatedPenicillium marneffeiinfection in southeast Asia. 7912350 [uid]."},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/520280"},{"key":"e_1_2_4_4_1","first-page":"688","article-title":"An efficacy study of itraconazole in the treatment of Penicillium marneffei infection","volume":"57","author":"Supparatpinyo K","year":"1992","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199812103392403"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000253374.19966.f9"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200203080-00022"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/374849"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/420749"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhiv.12921","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.12921","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.12921","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.12921","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T11:08:01Z","timestamp":1693825681000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.12921"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8]]},"references-count":8,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/hiv.12921"],"URL":"https:\/\/doi.org\/10.1111\/hiv.12921","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8]]},"assertion":[{"value":"2020-06-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}