Burden of Talaromyces marneffei infection in people living with HIV/AIDS in Asia during ART era: a systematic review and meta-analysis.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

HIV*; AIDS-Related Opportunistic Infections/*drug therapy ; AIDS-Related Opportunistic Infections/*epidemiology ; Anti-HIV Agents/*therapeutic use ; Mycoses/*epidemiology ; Talaromyces/*isolation & purification; AIDS-Related Opportunistic Infections/virology ; Asia, Southeastern/epidemiology ; CD4-Positive T-Lymphocytes ; China/epidemiology ; Humans ; India/epidemiology ; Lymphocyte Count ; Mycoses/microbiology ; Prevalence

Background: Talaromyces marneffei (TM) is a dimorphic fungus mainly prevalent in Southeast Asian countries, which often causes disseminated life-threatening infection. TM infection often occurs in HIV/AIDS patients even in the antiretroviral therapy (ART) era. However, there has as yet, not been a systematic analysis of the prevalence of TM infection in HIV-infected populations in Asia.
Methods: In this study, we searched Pubmed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and WanFang from inception to 21 November 2018 for studies reporting TM infection in people living with HIV/AIDS (PLWHA). Our meta-analysis included studies investigating the prevalence of TM infection in PLWHA. Reviews, duplicate studies, and animal studies were excluded. A random effects model was used to estimate pooled prevalence, and meta-regression analysis was conducted to explore potential factors for heterogeneity.
Results: 159,064 patients with HIV infection in 33 eligible studies were included in our meta-analysis. The pooled prevalence of TM infection in PLWHA was 3.6%. Vietnam had the highest prevalence (6.4%), followed by Thailand (3.9%), China (3.3%), India (3.2%) and Malaysia (2.1%). In China, TM infection was most prevalent in South China (15.0%), while the burden in Southwest China was not very heavy (0.3%). CD4+ T-cell counts below 200 cells/mm ³ contributed to the increased risk of TM infection in PLWHA (OR 12.68, 95%CI: 9.58-16.77). However, access to ART did not significantly decrease the risk of TM infection in PLWHA.
Conclusions: The burden of TM infection in Asia is heavy, and varies from region to region. PLWHA in lower latitude areas are more likely to suffer from TM infection. Optimization of diagnostic tools and universal screening for TM in vulnerable people to ensure early case detection and prompt antifungal treatment should be considered.

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2018ZX10302104,2017ZX10201101 the National Science and Technology Major Project of China during the 13th Five-year plan period; D161100000416003, D171100000517003 Major Project of Beijing Municipal Science and Technology Committee; No. 81701984 the National Natural Science Foundation of China; BZ0089 Beijing Key Laboratory; YNKTTS20180107 2018 Beijing Youan Hospital Scientific Research Project for Young & Middle-aged Talent's Cultivation; ZY201801003 Chongqing Municipal Science and Technology Bureau TCM Key Research Project

Keywords: HIV/AIDS; Meta-analysis; Prevalence; Talaromyces marneffei

0 (Anti-HIV Agents)

talaromycosis

Date Created: 20200731 Date Completed: 20200821 Latest Revision: 20200821

20240104

PMC7392840

10.1186/s12879-020-05260-8

32727383