{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T09:08:17Z","timestamp":1771405697651,"version":"3.50.1"},"posted":{"date-parts":[[2026,2,14]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":29,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,2,14]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                    Talaromycosis, caused by the fungus\n                    <jats:italic>Talaromyces marneffei<\/jats:italic>\n                    , is a leading cause of HIV-associated death in Southeast Asia. Current culture-based diagnosis only identifies late-stage infection, limiting understanding of disease burden and disease spectrum. We evaluated the clinical performance of anti-Mp1p IgM and IgG enzyme immunoassays (EIA) for talaromycosis diagnosis.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This diagnostic study included 423 adults with advanced HIV disease and culture-confirmed talaromycosis as cases, and 206 non-talaromycosis individuals with and without HIV who have never traveled to Asia as controls. Anti-Mp1p IgM and IgG antibodies were measured using conventional double-sandwich EIA. Diagnostic performance was assessed using the healthy control group and the HIV control group separately. Assay cut-offs were based on both the Youden index generated from the receiver operating characteristic curves, and separately using a pre-defined specificity of 95%.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At the pre-defined 95% specificity, IgM had low to moderate accuracy of 62.3% and 87.9%, and a low sensitivity of 8.3% and 21.3%, when evaluated with healthy and HIV controls, respectively. IgG had similarly low accuracy of 52.2% and 78.4%, and a low sensitivity of 21.5% and 30.5%, when evaluated using healthy and HIV controls, respectively. Both IgM and IgG assays performed better in HIV controls than healthy controls.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>\n                    The anti-Mp1p IgM and IgG EIAs show low utility for the diagnosis of acute talaromycosis. However, at the high specificity cut-off of 95%, the assays have utility in the detection of\n                    <jats:italic>T. marneffei<\/jats:italic>\n                    exposure at both individual and population levels, and. provides a foundation for future sero-epidemiological studies.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>IMPORTANCE<\/jats:title>\n                  <jats:p>\n                    Talaromycosis, caused by the dimorphic fungus\n                    <jats:italic>Talaromycosis marneffei<\/jats:italic>\n                    endemic in Southeast Asia, southern China, and northeastern India, is an invasive fungal infection that causes over 25,000 cases and 6,000 deaths annually but remains neglected in the global health community. Current diagnosis requiring culture-based testing is too slow, often resulting in patient death before treatment can begin. This study presents the first large-scale clinical evaluation of antibody tests for talaromycosis. While the antibody tests showed limited sensitivity for diagnosing acute disease, the high specificity makes them useful in determining prior exposure to\n                    <jats:italic>T. marneffei<\/jats:italic>\n                    , providing a new tool for public health investigation of disease prevalence at a population level, and for clinicians to identify individuals at risk for disease reactivation who may benefit from prevention strategies. The research provides important groundwork for improving disease control efforts in regions where this neglected infection is endemic.\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.02.08.26344333","type":"posted-content","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T15:40:19Z","timestamp":1771083619000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical Performance of a Mp1p Antibody Detection Immunoassay For Talaromycosis"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6667-2868","authenticated-orcid":false,"given":"Shanti","family":"Narayanasamy","sequence":"first","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, NC, USA"},{"name":"Department of Infectious Diseases and Immunology, Austin Health, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nguyen T.M.","family":"Thu","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew T","family":"Burke","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lottie","family":"Brown","sequence":"additional","affiliation":[{"name":"Institute of Infection and Immunity, City St George\u2019s University, School of Health & Medical Sciences, London, UK"},{"name":"Clinical Infection Unit, St George\u2019s Hospital, St George\u2019s Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sruthi","family":"Venugopalan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Nevada Reno School of Medicine, Nevada, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph R.","family":"Egger","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vo Trieu","family":"Ly","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam"},{"name":"Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9320-4050","authenticated-orcid":false,"given":"Ngo","family":"Hoa Thi","sequence":"additional","affiliation":[{"name":"Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam"},{"name":"Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom"},{"name":"Tropical Medicine Research Center for Talaromycosis, Center for Biomedical Research, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thuy","family":"Le","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, Duke University School of Medicine, Durham, North Carolina, USA"},{"name":"Tropical Medicine Research Center for Talaromycosis, Center for Biomedical Research, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2026021800201214000_2026.02.08.26344333v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30303-1"},{"key":"2026021800201214000_2026.02.08.26344333v1.2","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-012-9577-0"},{"key":"2026021800201214000_2026.02.08.26344333v1.3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir028"},{"key":"2026021800201214000_2026.02.08.26344333v1.4","doi-asserted-by":"crossref","unstructured":"Jiang J , Meng S , Huang S , et al. 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