Immunodeficiency Disease Spectrum in HIV-Negative Individuals with Talaromycosis
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LETTER TO EDITOR
Immunodeficiency Disease Spectrum in HIV-Negative Individuals with Talaromycosis Ye Qiu 1,2,3 & Xin Feng 2 & Wen Zeng 2 & Hui Zhang 2 & Jianquan Zhang 1 Received: 29 April 2020 / Accepted: 15 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
To the Editor: The dimorphic fungus Talaromyces marneffei is an important endemic pathogen that can cause life-threatening mycoses in immunocompromised individuals living in or traveling to Southeast Asia and southern China [1]. Historically, talaromycosis was considered to cause infection only in individuals with human immunodeficiency virus (HIV) infection, and so it was classified as an acquired immunodeficiency syndrome (AIDS)-defining illness. In recent years, improved treatment of HIV infection has led to a change in the epidemiology of T. marneffei infection, with an increasing number and proportion of cases being reported in individuals with other immunocompromising conditions [2]. However, information on the spectrum of immunodeficiencies and underlying diseases associated with T. marneffei infection among HIV-negative individuals is limited. Furthermore, the differences in the spectrum of underlying disease, T. marneffei isolation, and prognosis between adults and children are unclear. Herein, we report the epidemiologic characteristics and underlying disease spectrum of talaromycosis among 275 HIVnegative individuals using data from a retrospective study conducted in Guangxi, China (91 cases), combined with 184
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10875-020-00869-5) contains supplementary material, which is available to authorized users. * Jianquan Zhang [email protected] 1
Department of Respiratory and Critical Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, No. 3025, Shennan Middle Road, Shenzhen 518000, Guangdong, China
2
Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
3
Department of Comprehensive Internal Medicine, Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi, China
cases identified using a systematic literature review (Online Resource 1). Detailed methods are provided in Online Resource File 6. In addition, we compared the spectrum of underlying disease, T. marneffei isolation, and prognosis between HIV-negative adults and children. Talaromycosis mostly occurs in individuals with HIV infection and a low CD4 count [2] suggesting that HIV-negative individuals may have potentially unrecognized immunodeficiency, especially those with fatal disseminated disease. In this study, a total of 318 cases of talaromycosis in HIV-negative individuals were identified in the systematic literature review, and there were 150 HIV-negative patients with talaromycosis identified in the retrospective study. After excluding 12 duplicate cases that were identified in the literature review and the retrospective study, there were 456 cas
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