{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:40:34Z","timestamp":1791265234102,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,12,25]],"date-time":"2020-12-25T00:00:00Z","timestamp":1608854400000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Talaromycosis is an invasive mycosis endemic to Southeast Asia. This study aimed to investigate the epidemiology, clinical features and prognostic factors of HIV\u2010associated talaromycosis in Guangdong, China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively evaluated HIV patients hospitalized with histopathology\u2010 or culture\u2010confirmed talaromycosis between 2011 and 2017. Factors associated with poor prognosis were identified using logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 1079 patients with HIV\u2010associated talaromycosis were evaluated. Both the number and prevalence of talaromycosis among HIV admissions increased from 125 and 15.7% in 2011 to 253 and 18.8% in 2017, respectively, reflecting the increase in HIV admissions. Annual admissions peaked during the rainy season between March and August. Common clinical manifestations included fever (85.6%), peripheral lymphadenopathy (72.3%), respiratory symptoms (60.8%), weight loss (49.8%), skin lesions (44.5%) and gastrointestinal symptoms (44.3%). Common laboratory abnormalities were hypoalbuminaemia (98.6%), anaemia (95.6%), elevated aspartate aminotransferase level (AST) (76.9%), elevated alkaline phosphatase level (55.8%) and thrombocytopenia (53.7%). The median CD4 count was 9\u00a0cells\/\u03bcL. <jats:italic>Talaromyces marneffei<\/jats:italic> was isolated from blood and bone marrow cultures of 66.6% and 74.5% of patients, respectively. The rate increased to 86.6% when both cultures were performed concurrently. At discharge, 14% of patients showed worsening conditions or died. Leucocytosis, thrombocytopenia, elevated AST, total bilirubin, creatinine and azole monotherapy independently predicted poor prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of HIV\u2010associated talaromycosis has increased in Guangdong with the high HIV burden in China. Skin lesions were seen in less than half of patients. Induction therapy with azole alone is associated with higher mortality. Findings from this study should help to improve treatment of the disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13024","type":"journal-article","created":{"date-parts":[[2020,12,25]],"date-time":"2020-12-25T13:24:21Z","timestamp":1608902661000},"page":"729-738","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":74,"title":["Clinical epidemiology and outcome of HIV\u2010associated talaromycosis in Guangdong, China, during 2011\u20132017"],"prefix":"10.1111","volume":"21","author":[{"given":"RS","family":"Ying","sequence":"first","affiliation":[{"name":"Infectious Disease Center Guangzhou Eighth People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Le","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health Duke University School of Medicine Durham NC USA"},{"name":"Oxford University Clinical 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Prevention the National Institutes of Health and the HIV Medicine Association of the Infectious Diseases Society of America.Guidelines for prevention and treatment of opportunistic infections in HIV\u2010infected adults and adolescents. Available athttp:\/\/aidsinfo.nih.gov\/guidelines(accessed 01 January 2011)."},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir028"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-6405-9-24"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-464"},{"key":"e_1_2_7_21_1","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1093\/cid\/cit058","article-title":"Environmental predictors and incubation period of AIDS\u2010associated Penicillium marneffei infection in Ho Chi Minh City, Vietnam","volume":"56","author":"Philip LB","year":"2013","journal-title":"Clin Infect Dis"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/173.6.1490"},{"key":"e_1_2_7_23_1","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1684\/ejd.2010.0904","article-title":"Disseminated Penicillium marneffei infection with verrucoid lesions in an AIDS patient in Beijing, a non\u2010endemic region","volume":"20","author":"Li H","year":"2010","journal-title":"Eur J Dermatol"},{"key":"e_1_2_7_24_1","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.4269\/ajtmh.16-0521","article-title":"Clinical characteristics and prognosis of penicilliosis among human immunodeficiency virus\u2010infected patients in Eastern China","volume":"96","author":"Chen J","year":"2017","journal-title":"Am J Trop Med Hyg"},{"key":"e_1_2_7_25_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.4103\/0378-6323.58692","article-title":"Penicillium marneffei infection in Assam","volume":"76","author":"Saikia L","year":"2010","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"e_1_2_7_26_1","first-page":"181","article-title":"Evaluation of quantitative real\u2010time PCR and Platelia Galactomannan assays for the diagnosis of disseminated Talaromyces marneffei infection","volume":"58","author":"Li X","year":"2020","journal-title":"Med Mycol"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00050-07"},{"key":"e_1_2_7_28_1","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1093\/mmy\/myy162","article-title":"Rapid and robust identification of clinical isolates of Talaromyces marneffei based on MALDI\u2010TOF mass spectrometry or dimorphism in Galleria mellonella","volume":"57","author":"Borman AM","year":"2019","journal-title":"Med Mycol"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12530"},{"key":"e_1_2_7_30_1","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.4269\/ajtmh.16-0521","article-title":"Clinical characteristics and prognosis of Penicilliosis among human immunodeficiency virus\u2010infected patients in Eastern China","volume":"96","author":"Chen J","year":"2017","journal-title":"Am J Trop Med Hyg"},{"key":"e_1_2_7_31_1","first-page":"ciaa826","article-title":"Superiority of a novel Mp1p antigen detection enzyme immunoassay compared to standard BACTEC blood culture in the diagnosis of talaromycosis","volume":"21","author":"Thu NTM","year":"2020","journal-title":"Clin Infect Dis"},{"key":"e_1_2_7_32_1","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents.Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. 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