非HIV马尔尼菲篮状菌病免疫相关易感因素分析

Analysis of susceptibility factors forinfection with Talaromyces marneffei in non-HIV individuals

目的 对HIV阴性的马尔尼菲篮状菌病(TSM)患者的免疫相关易感因素进行分析,以提高临床医师对这一疾病的认识和管理。方法 前瞻性研究本课题组收集的来自广西及国内其他省市2012年至2021年确诊为HIV阴性的TSM患者临床特点,分析其免疫相关易感因素。结果 纳入患者154例,132例检出免疫缺陷。儿童患者以原发性免疫缺陷病为主;成人患者以抗伽马干扰素自身抗体相关的免疫缺陷综合征为主,其余包括合并恶性肿瘤及结缔组织病等基础病。结论TSM可发生于存在不同形式免疫缺陷的非HIV患者,应基于易感因素建立完整的免疫状态评估策略,以改善患者预后。

Objective To analyze the immune-related susceptibility factors of Talaromyces marneffei infection(TSM)in non-HIV patients,so as to improve the understanding and management of this disease among clinicians.Methods The clinical characteristics of HIV-negative patients diagnosed with TSM from 2012 to 2021 in Guangxi and other provinces and cities in China collected by our group were prospectively studied to analyse their immune-related susceptibility factors.Results 154 patients were included,and immunodeficiency was detected in 132 cases.Primary immunodeficiency diseases predominated in pediatric patients;immunodeficiency syndrome associated with anti-interferon-gamma autoantibodies predominated in adult patients,and the remainder included co-morbid malignancies and underlying diseases such as connective tissue disease.Conclusion TSM can occur in non-HIV patients with different forms of immunodeficiency and a complete immune status assessment strategy based on susceptibility factors should be established to improve patient prognosis.