Epidemiological and clinical features of talaromycosis (Penicilliosis) marneffei among human immunodeficiency virus-infected patients in Malaysia
The AIDS epidemic in Southeast Asia has led to a marked rise in the incidence of talaromycosis (penicilliosis) marneffei. The aim of this cross-sectional study was to determine the clinico-epidemiological features and outcome predictors of talaromycosis in Malaysia. We identified Talaromycosis...
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| Format: | Article |
| Language: | English |
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Pusat Perubatan Universiti Kebangsaan Malaysia
2018
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| Online Access: | http://journalarticle.ukm.my/20611/ http://journalarticle.ukm.my/20611/1/10_ms406_pdf_17905.pdf |
| _version_ | 1848815148221857792 |
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| author | Syaziah I, Azura SS, Tzar Mohd Nizam Khaithir, |
| author_facet | Syaziah I, Azura SS, Tzar Mohd Nizam Khaithir, |
| author_sort | Syaziah I, |
| building | UKM Institutional Repository |
| collection | Online Access |
| description | The AIDS epidemic in Southeast Asia has led to a marked rise in the incidence
of talaromycosis (penicilliosis) marneffei. The aim of this cross-sectional study
was to determine the clinico-epidemiological features and outcome predictors
of talaromycosis in Malaysia. We identified Talaromycosis marneffei cases from
cultures of sterile specimens from 191 human immunodeficiency virus (HIV)-
infected patients. Talaromycosis increased from 20-25 (2010-2011) to 45-50 cases
per year (2012-2014). Talaromycosis was the HIV-presenting illness in 117 (61.3%)
patients. The incidence of talaromycosis as HIV-presenting illness showed an
increasing trend from 10.7 (2010) to 26.4 (2014) cases per 1000 new HIV patients.
The patients were between 19 and 74 of age (mean 37.2+9.4 years) and the male to
female ratio was 7.7:1. Malay (73, 38.2%) and Chinese (70, 36.3%) were the most
prevalent ethnic groups. Common clinical manifestations included loss of weight
(85.9%), fever (84.8%) and cough (67%), while skin lesions were only present
in 42.9% cases. Common concurrent infections were oral candidiasis (79.6%),
tuberculosis (36.1%) and hepatitis C infection (20.9%). Most patients (93.7%)
were anaemic with mean haemoglobin level of 9.9+2.3 g/dL, 39% had impaired
liver function, and 18.8% were neutropaenic. Median CD4 cell count was 16
cells/L. Most patients (70.4%) received intravenous amphotericin B followed by
itraconazole. At 8-month follow up, 148 (81.8%) patients were alive while 33
(18.2%) had died. Intravenous drug abuse, concurrent toxoplasma encephalitis
and concurrent Pneumocystis jiroveci pneumonia independently predicted death
outcome in both univariate and multivariate logistic regression analyses. |
| first_indexed | 2025-11-15T00:45:22Z |
| format | Article |
| id | oai:generic.eprints.org:20611 |
| institution | Universiti Kebangasaan Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T00:45:22Z |
| publishDate | 2018 |
| publisher | Pusat Perubatan Universiti Kebangsaan Malaysia |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | oai:generic.eprints.org:206112022-11-28T13:02:44Z http://journalarticle.ukm.my/20611/ Epidemiological and clinical features of talaromycosis (Penicilliosis) marneffei among human immunodeficiency virus-infected patients in Malaysia Syaziah I, Azura SS, Tzar Mohd Nizam Khaithir, The AIDS epidemic in Southeast Asia has led to a marked rise in the incidence of talaromycosis (penicilliosis) marneffei. The aim of this cross-sectional study was to determine the clinico-epidemiological features and outcome predictors of talaromycosis in Malaysia. We identified Talaromycosis marneffei cases from cultures of sterile specimens from 191 human immunodeficiency virus (HIV)- infected patients. Talaromycosis increased from 20-25 (2010-2011) to 45-50 cases per year (2012-2014). Talaromycosis was the HIV-presenting illness in 117 (61.3%) patients. The incidence of talaromycosis as HIV-presenting illness showed an increasing trend from 10.7 (2010) to 26.4 (2014) cases per 1000 new HIV patients. The patients were between 19 and 74 of age (mean 37.2+9.4 years) and the male to female ratio was 7.7:1. Malay (73, 38.2%) and Chinese (70, 36.3%) were the most prevalent ethnic groups. Common clinical manifestations included loss of weight (85.9%), fever (84.8%) and cough (67%), while skin lesions were only present in 42.9% cases. Common concurrent infections were oral candidiasis (79.6%), tuberculosis (36.1%) and hepatitis C infection (20.9%). Most patients (93.7%) were anaemic with mean haemoglobin level of 9.9+2.3 g/dL, 39% had impaired liver function, and 18.8% were neutropaenic. Median CD4 cell count was 16 cells/L. Most patients (70.4%) received intravenous amphotericin B followed by itraconazole. At 8-month follow up, 148 (81.8%) patients were alive while 33 (18.2%) had died. Intravenous drug abuse, concurrent toxoplasma encephalitis and concurrent Pneumocystis jiroveci pneumonia independently predicted death outcome in both univariate and multivariate logistic regression analyses. Pusat Perubatan Universiti Kebangsaan Malaysia 2018-12 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/20611/1/10_ms406_pdf_17905.pdf Syaziah I, and Azura SS, and Tzar Mohd Nizam Khaithir, (2018) Epidemiological and clinical features of talaromycosis (Penicilliosis) marneffei among human immunodeficiency virus-infected patients in Malaysia. Medicine & Health, 13 (2). pp. 103-113. ISSN 2289-5728 https://www.medicineandhealthukm.com/toc/13/2 |
| spellingShingle | Syaziah I, Azura SS, Tzar Mohd Nizam Khaithir, Epidemiological and clinical features of talaromycosis (Penicilliosis) marneffei among human immunodeficiency virus-infected patients in Malaysia |
| title | Epidemiological and clinical features of talaromycosis (Penicilliosis) marneffei among human immunodeficiency virus-infected patients in Malaysia |
| title_full | Epidemiological and clinical features of talaromycosis (Penicilliosis) marneffei among human immunodeficiency virus-infected patients in Malaysia |
| title_fullStr | Epidemiological and clinical features of talaromycosis (Penicilliosis) marneffei among human immunodeficiency virus-infected patients in Malaysia |
| title_full_unstemmed | Epidemiological and clinical features of talaromycosis (Penicilliosis) marneffei among human immunodeficiency virus-infected patients in Malaysia |
| title_short | Epidemiological and clinical features of talaromycosis (Penicilliosis) marneffei among human immunodeficiency virus-infected patients in Malaysia |
| title_sort | epidemiological and clinical features of talaromycosis (penicilliosis) marneffei among human immunodeficiency virus-infected patients in malaysia |
| url | http://journalarticle.ukm.my/20611/ http://journalarticle.ukm.my/20611/ http://journalarticle.ukm.my/20611/1/10_ms406_pdf_17905.pdf |