Abstract
BackgroundTalaromyces marneffei (T. marneffei) infection has been associated with adult-onset immunodeficiency due to anti-IFN-γ autoantibodies. We aimed to investigate the clinical features of non-HIV-infected patients with T. marneffei infection in southern China.MethodsBetween January 2018 and September 2020, we enrolled patients with T. marneffei infection who were HIV-negative (group TM, n = 42), including anti-IFN-γ autoantibody-positive (group TMP, n = 22) and anti-IFN-γ autoantibody-negative (group TMN, n = 20) patients and healthy controls (group HC, n = 40). Anti-IFN-γ autoantibodies were detected by ELISA. Clinical characteristics and clinical laboratory parameters were recorded.ResultsCompared with anti-IFN-γ autoantibody-negative patients with T. marneffei infection, anti-IFN-γ autoantibody-positive patients did not have underlying respiratory disease; more frequently exhibited dissemination of systemic infections with severe pleural effusion; had higher WBC counts, C-reactive protein levels, erythrocyte sedimentation rates, and neutrophil and CD8+ T cell counts; had lower hemoglobin levels; and were more likely to have other intracellular pathogen infections. Most of these patients had poor outcomes despite standardized antimicrobial therapy.ConclusionT. marneffei-infected patients with higher anti-IFN-γ autoantibody titers have more severe disease and complex clinical conditions.
Highlights
IntroductionImmune deficiency, which is caused by anti-interferon-γ autoantibodies (anti-IFN-γ Anti-interferon-γ autoantibodies (autoAbs)), is an adult immune deficiency syndrome that was first described among patients with mycobacterial infection [1]
Immune deficiency, which is caused by anti-interferon-γ autoantibodies, is an adult immune deficiency syndrome that was first described among patients with mycobacterial infection [1]
T. marneffei infection has been increasingly reported among non-human immunodeficiency virus (HIV)-infected patients with impaired cell-mediated immunity [16], and immune deficiency syndrome caused by anti-IFN-γ Anti-interferon-γ autoantibodies (autoAbs) is an important risk factor [11, 12]
Summary
Immune deficiency, which is caused by anti-interferon-γ autoantibodies (anti-IFN-γ autoAbs), is an adult immune deficiency syndrome that was first described among patients with mycobacterial infection [1]. T. marneffei infection has long been associated with acquired immunodeficiency syndrome caused by human immunodeficiency virus (HIV) infection [14]. In some regions, such as southern China, T. marneffei infection has historically been the major opportunistic infection associated with acquired immunodeficiency syndrome [15]. T. marneffei infection has been increasingly reported among non-HIV-infected patients with impaired cell-mediated immunity [16], and immune deficiency syndrome caused by anti-IFN-γ autoAbs is an important risk factor [11, 12]. We aimed to investigate the clinical features of non-HIV-infected patients with T. marneffei infection in southern China
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