{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T06:03:19Z","timestamp":1778047399509,"version":"3.51.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013248","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000}}],"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI143409"],"award-info":[{"award-number":["R01AI143409"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["U01AI169358"],"award-info":[{"award-number":["U01AI169358"]}],"id":[{"id":"10.13039\/100000009","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>Several antigen-detection assays have been developed for the rapid diagnosis of talaromycosis<jats:italic>,<\/jats:italic> but their utility has been limited by a lack of commercial options. The aim of this study was to perform a head-to-head comparison of the performance of our in-house monoclonal antibody-based Mp1p antigen-detecting enzyme immunoassay (EIA) with its recently-developed commercial platform.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In this diagnostic accuracy, retrospective, case-cohort study, we compared the sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) of the commercial Wantai Mp1p EIA <jats:italic><jats:italic>versus<\/jats:italic><\/jats:italic> our in-house Mp1p EIA on paired plasma and urine samples from 424 hospitalized adults with advanced HIV disease, including 224 cases of proven talaromycosis, where <jats:italic><jats:italic>Talaromyces marneffei<\/jats:italic><\/jats:italic> was isolated in culture of blood or other clinical specimens, and 200 controls diagnosed with a range of other opportunistic infections. All participants were randomly selected from prospective cohorts recruited between 2011 and 2019 from five centers in Vietnam.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The sensitivity of the Wantai and in-house Mp1p EIAs were comparable in plasma (95.1% <jats:italic><jats:italic>vs<\/jats:italic><\/jats:italic> 92.4%, <jats:italic><jats:italic>P<\/jats:italic><\/jats:italic>\u2009=\u20090.11), in urine (91.5% <jats:italic><jats:italic>vs<\/jats:italic><\/jats:italic> 87.1% <jats:italic><jats:italic>P<\/jats:italic><\/jats:italic>\u2009=\u20090.07), and in combined testing of plasma and urine (96.4% <jats:italic><jats:italic>vs<\/jats:italic><\/jats:italic> 96.0%, <jats:italic><jats:italic>P<\/jats:italic><\/jats:italic>\u2009=\u20091.00), where talaromycosis was diagnosed based on the positivity of either specimen. The specificity of the Wantai and in-house Mp1p EIAs were consistently high in plasma, in urine, and in combined testing (93 \u2013 97%). The Wantai and in-house Mp1p EIAs provided substantially higher sensitivity than blood culture detection (96.4% and 96.0% <jats:italic><jats:italic>vs<\/jats:italic><\/jats:italic> 78.6%, <jats:italic><jats:italic>P<\/jats:italic><\/jats:italic>\u2009&lt;\u20090.001). For both EIAs, LR+ were greater than 10 and LR- were less than 0.1, which increases the confidence to rule in or rule out talaromycosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The diagnostic performance of the Wantai Mp1p EIA was comparable to our validated in-house Mp1p EIA, and significantly more sensitive than blood culture, offering a standardized tool for the rapid diagnosis of talaromycosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013248","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T17:58:28Z","timestamp":1754071108000},"page":"e0013248","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparative performance of a commercial and in-house Mp1p antigen-detecting enzyme immunoassay for the rapid diagnosis of 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