Clinical characteristics and outcome of Penicillium marneffei infection among HIV-infected patients in northern Vietnam

Larsson, M

Nguyen, LHT

Wertheim, HFL

Dao, TT

Taylor, W

Horby, P

Nguyen, TV

Nguyen, MHT

Le, T

Nguyen, KV

2018-03-16T19:37:34Z

2018-03-16T19:37:34Z

2012-08-16

Objective: This study reports the clinical characteristics and outcome of HIV-associated Penicilliummarneffei infection in northern Vietnam.Methods: We conducted a retrospective chart review of all patients with laboratory confirmed Penicilliummarneffei infection admitted to the National Hospital for Tropical Diseases in Hanoi, Vietnam, between July 2006 and September 2009.Results: 127 patients with P. marneffei infection were identified. All were HIV-infected; median CD4+ T-cell count was 24 cells/μl (IQR:12-48); 76% were men. Common clinical features were fever (92.9%), skin lesions (82.6%), hepatomegaly (61.4%), lymphadenopathy (40.2%), weight loss (59.1%) and cough (49.6%). Concurrent opportunistic infections were present in 22.0%; half of those had tuberculosis. Initial treatment regimens were: itraconazole or ketoconazole capsule (77.2%), amphotericin B (20.5%), and fluconazole (1.6%). In-hospital mortality was 12.6% and showed no significant difference in patients treated with itraconazole (or ketoconazole) and amphotericin B (p = 0.43). Dyspnea, ascites, and increased LDH level were independent predictors of mortality. No seasonality was observed.Conclusion: The clinical features, treatments and outcomes of HIV-associated P. marneffei infection in northern Vietnam are similar to those reported in other endemic regions. Dyspnea was an important predictor of mortality. More patients were treated with itraconazole than amphotericin B and no significant difference in treatment outcome was observed. It would be of clinical value to compare the efficacy of oral itraconazole and amphotericin B in a clinical trial. © 2012 Larsson et al.; licensee BioMed Central Ltd.

1742-6405

https://hdl.handle.net/10161/16192

Springer Science and Business Media LLC

AIDS Research and Therapy

10.1186/1742-6405-9-24

Clinical characteristics and outcome of Penicillium marneffei infection among HIV-infected patients in northern Vietnam

Journal article

Le, T|0000-0002-3393-6580

Clinical Science Departments

Duke

Medicine

Medicine, Infectious Diseases

School of Medicine

Published

9