{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T18:07:38Z","timestamp":1778695658093,"version":"3.51.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013012","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000}}],"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019031","name":"Chongqing Municipal Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2301900-2021YFC2301901"],"award-info":[{"award-number":["2021YFC2301900-2021YFC2301901"]}],"id":[{"id":"10.13039\/501100019031","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The optimal initial induction treatment for HIV-associated <jats:italic>Talaromyces marneffei<\/jats:italic> fungemia (HTMF) remains unclear.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Three hundred and fifteen patients with HIV-associated <jats:italic>Talaromyces marneffei<\/jats:italic> were enrolled in this multicenter retrospective study. The effectiveness of induction regimens with amphotericin B deoxycholate (iAmBd), voriconazole (iVori), and a switch regimen from iVori to AmBd (iVori\u2192AmBd switch) on 180-day all-cause mortality in HTMF patients was assessed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The prevalence of HTMF was 75.9% (239\/315) with a 180-day all-cause mortality of 20.1% (48\/239). Among these HTMF patients, 44.4% (106\/239) were treated with iAmBd, 41.8% (100\/239) with iVori, and 13.8% (33\/239) with other regimens. Additionally, 53% (53\/100) of patients treated with iVori underwent an iVori\u2192AmBd switch within 7 days. The 180-day cumulative survival rates were 88.7% for patients treated with iAmBd and 77.0% for those treated with iVori; 88.8% for patients who received AmBd within 3 days (iAmBd + 3-day iVori\u2192AmBd switch) and 72.2% for those who continued iVori; 88.2% for patients who received AmBd within 5 days (iAmBd + 5-day iVori\u2192AmBd switch) and 71.0% for those who continued iVori; 88.1% for those who received AmBd within 7 days (iAmBd + 7-day iVori\u2192AmBd switch) and 66.0% for those who continued iVori (all log-rank P &lt; 0.020). The prevalence of adverse drug reactions (ADRs) was 24.5% in the iAmBd group and 9.0% in the iVori group in induction stage (P &lt; 0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Voriconazole is inferior to AmBd as an initial induction therapy for HTMF patients. Early AmBd administration or an early iVori\u2192AmBd switch improves survival, despite the higher incidence of AmBd-related ADRs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013012","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T18:26:45Z","timestamp":1744136805000},"page":"e0013012","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Voriconazole is inferior to amphotericin B deoxycholate as the initial induction therapy for HIV-associated Talaromyces marneffei fungemia: A multicenter retrospective 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