title: Serological surveillance for Penicillium marneffei infection in HIV-infected patients during 2004-2011 in Guangzhou, China.
abstract: Prevalence of disseminated Penicillium marneffei infection is not known in human immunodeficiency virus (HIV)-infected patients. This retrospective study aimed to evaluate the prevalence of and risk factors for disseminated P. marneffei infection in HIV-infected patients during 2004-11 in Guangzhou, China. We tested 8131 archived HIV-infected patient serum samples for P. marneffei-specific mannoprotein (Mp1p) antigen using a highly sensitive and specific ELISA that we previously established. The CD4 count of 2686 cases was determined by flow cytometry. Logistic regression was used to assess predictors of Mp1p antigenaemia. The overall prevalence of disseminated penicilliosis as detected by positive serum Mp1p antigen was 9.36% (761/8131), in good concordance with Platelia™ Aspergillus immunoassay. During 2004-11, the prevalence increased to a peak of 12.58% (158/1256) in 2010 and decreased in 2011. Penicilliosis was strongly associated with progression from HIV to AIDS (OR 4.66, 95% CI 3.94-5.51, p <0.001) and humidity (OR 1.02, 95% CI 1.01-1.03, p 0.002). Disseminated penicilliosis occurred mainly during the rainy seasons (p <0.001). For 2686 cases with known CD4 count, logistic regression showed that CD4 count of <200 cells/μL was a risk factor for penicilliosis (OR 2.90, 95% CI 1.10-7.66, p 0.032), especially when it was <50 cells/μL (OR 24.26, 95% CI 10.63-55.36, p <0.001) during which 28.06% of patients developed disseminated penicilliosis. In conclusion, approximately 9.36% of the HIV-infected patients in our study developed disseminated penicilliosis. Rapid diagnosis may be achieved by performing serological surveillance for Mp1p antigenaemia as a routine procedure for all HIV-infected patients with CD4 count of <50 cells/μL.
authors: Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Laboratory of Emerging Infectious Diseases, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors: Y-F
authors: YF
authors: Wang
authors: Guangzhou Centre for Disease Control and Prevention, Guangzhou, China.
authors: H-F
authors: HF
authors: Xu
authors: Guangzhou Centre for Disease Control and Prevention, Guangzhou, China.
authors: Z-G
authors: ZG
authors: Han
authors: Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Laboratory of Emerging Infectious Diseases, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors: L
authors: L
authors: Zeng
authors: Guangzhou Centre for Disease Control and Prevention, Guangzhou, China.
authors: C-Y
authors: CY
authors: Liang
authors: Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Laboratory of Emerging Infectious Diseases, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors: X-J
authors: XJ
authors: Chen
authors: Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Laboratory of Emerging Infectious Diseases, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors: Y-J
authors: YJ
authors: Chen
authors: State Key Laboratory of Emerging Infectious Diseases, Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China.
authors: J-P
authors: JP
authors: Cai
authors: Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Laboratory of Emerging Infectious Diseases, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors: W
authors: W
authors: Hao
authors: State Key Laboratory of Emerging Infectious Diseases, Department of Microbiology, The University of Hong Kong, Hong Kong Special Administrative Region, China. Electronic address: jfwchan@hku.hk.
authors: J F-W
authors: JF
authors: Chan
authors: Guangzhou Centre for Disease Control and Prevention, Guangzhou, China. Electronic address: wangming@gzcdc.org.cn.
authors: M
authors: M
authors: Wang
authors: Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Laboratory of Emerging Infectious Diseases, Zhujiang Hospital, Southern Medical University, Guangzhou, China. Electronic address: zfzn2013@126.com.
authors: N
authors: N
authors: Fu
authors: Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Laboratory of Emerging Infectious Diseases, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors: X-Y
authors: XY
authors: Che
mesh_terms: D000328:Adult; D000946:Antigens, Fungal / Q000097:blood*; D018791:CD4 Lymphocyte Count; D002681:China / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D062665:Epidemiological Monitoring; D005260:Female; D005434:Flow Cytometry; D016469:Fungemia / Q000453:epidemiology* / Q000382:microbiology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008562:Membrane Glycoproteins / Q000097:blood*; D010407:Penicillium / Q000302:isolation & purification*; D012189:Retrospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies
chemical_list: D000946:Antigens, Fungal; D008562:Membrane Glycoproteins; C025363:mannoproteins
keywords: AIDS; HIV; Mp1p; Penicillium marneffei; penicilliosis