HIV-associated talaromycosis: Does timing of antiretroviral therapy matter? - 02/03/22

Doi : 10.1016/j.jinf.2021.12.032

Yuanyuan Qin ^a,^{^{1
These authors have contributed equally to the work.}}, Yihong Zhou ^a,^{^{1
These authors have contributed equally to the work.}}, Songtao Liu ^a,^{^{1
These authors have contributed equally to the work.}}, Yanqiu Lu ^a, Min Liu ^a, Jing Yuan ^a, Jingmin Nie ^a, Jing Ouyang ^a, Hao Wu ^b, Yingmei Qin ^c, Zhongsheng Jiang ^d, Guoqiang Zhou ^e, Qun Tian ^f, Ke Lan ^g, Yang Zhou ^h, Xinping Yang ⁱ, Kaiyin He ^j, Jun Liu ^k, Vijay Harypursat ^a, Yaokai Chen ^a,^⁎
^a Division of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China
^b Department of Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
^c Department of Infectious Diseases, the Fourth People's Hospital of Nanning, Guangxi, China
^d Department of Infectious Diseases, Liuzhou General Hospital, Guangxi, China
^e Department of Infectious Diseases, the First Hospital of Changsha, Hunan, China
^f Department of Infectious Diseases, the Third People's Hospital of Guilin, Guangxi, China
^g Department of Infectious Disease, Longtan Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
^h Department of Infectious Diseases, the Third People's Hospital of Shenzhen, Guangdong, China
ⁱ Department of Infectious Diseases, Yunnan Provincial Infectious Disease Hospital, Yunnan, China
^j Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangdong, China
^k Department of Infectious Diseases, Kunming Third People's Hospital, Yunnan, China

^⁎Corresponding author: Division of Infectious Diseases, Chongqing Public Health Medical Center, 109 Baoyu Road, Shapingba, Chongqing 400036, China.Division of Infectious DiseasesChongqing Public Health Medical Center109 Baoyu RoadShapingbaChongqing400036China

Abstract

Objectives

: No current academic data is available with respect to the optimal timing to initiate antiretroviral therapy (ART) in HIV-positive patients with talaromycosis. Our study aimed to evaluate the optimal timing of ART initiation for patients presenting with AIDS-related talaromycosis.

Methods

: In this prospective, randomized, open-label multicenter trial, 228 patients from 15 hospitals in China were randomly assigned to an early ART group (initiation of ART within 2 weeks after randomization) and a deferred ART group (initiation of ART 2 weeks after randomization). The primary endpoint was all-cause mortality during the 48 weeks after randomization.

Results

: We observed a significant difference in mortality between the early ART group and the deferred ART group (2.2% vs. 8.9%, 95%CI: -0.15 to 14.05, p = 0.049). The composite outcome of AIDS-defining events or death in the early ART group was found to be lower than that in the deferred ART group (3.3% vs. 14.9%; 95%CI: 2.93 to 19.23, p = 0.008).

Conclusions

: The prognosis of HIV-infected patients with talaromycosis in the early ART group was more favorable than that of patients in the deferred ART group. These results demonstrate that early ART initiation should be considered in HIV-infected patients with talaromycosis .

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Keywords : HIV, AIDS, Talaromyces marneffei infection, Antiretroviral therapy, Opportunistic infection, Talaromycosis

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Vol 84 - N° 3

P. 410-417 - mars 2022 Retour au numéro

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HIV-associated talaromycosis: Does timing of antiretroviral therapy matter? - 02/03/22

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