106例HIV合并马尔尼菲篮状菌感染特征及预后不良相关因素分析OACSTPCD

Objective To analyze the characteristics of HIV positive cases with Talaromyces mameffei infection and the associated factors of poor prognosis.Methods A retrospective analysis was performed to analyze the general characteristic,clinical comorbidities and prognostic correlation of 106 cases of HIV positive cases complicated with Talaromyces mameffei infection from February 2020 to December 2023 in The People's Hospital of Hechi.Results There were statistical differences in the progression of HIV-TSM infection between Zhuang and other ethnic groups(P＜0.05).The comorbidities of sepsis,metabolic acidosis and thrombocytopenia showed significantly different composition ratio between the improved group and the deteriorating group(P＜0.001).In univariate Cox analysis,metabolic acidosis,thrombocytopenia and sepsis were correlate-d with severe symptoms.In multivariate Cox analysis,thrombocytopenia was as an independent risk factor for severe disease(HR=2.955,95％CI=1.304～6.699;P=0.009),metabolic acidosis was an independent risk factor for severe disease(HR=6.219,95％CI=2.740～14.116;P＜0.001).Kaplan-Meier analysis suggested that thrombocytopenia was associated with HIV-TSM prognosis(Log-Rand,x2=11.511,P＜0.001),and metabolic acidosis was associated with HIV-TSM prog-nosis(Log-Rand,=44.847,P＜0.001).The area under ROC curve predicted by thrombocytopenia combined with meta-bolic acidosis was 0.794(P＜0.001,95％CI:0.690～0.892).Conclusion Compared with other ethnic groups,Zhuang pop-ulation in northwestern Guangxi has a significant difference in the poor prognosis of HIV-TSM infection,thrombocytopenia and metabolic acidosis are independent risk factors for the poor prognosis of HIV-TSM infection.