Renfang Zhang

Talaromyces marneffei infection is increasingly observed in people living with human immunodeficiency virus (HIV) in eastern China, a nonendemic area. This study aimed to draw the clinician's attention to this disease by presenting the clinical characteristics and prognosis of penicilliosis among HIV-infected patients from this region. We retrospectively analyzed HIV-infected patients with culture-proven T. marneffei infection admitted during January 1, 2014–December 31, 2015, at the Shanghai Public Health Clinical Center. A total of 48 patients with confirmed HIV infection and penicilliosis were enrolled, which accounted for a mean of 3.2% (95% confidence interval: 2.4–4.2%) of yearly HIV infection admissions among patients from eastern China. Symptoms included fever, cough, and gastrointestinal complaints, whereas the most common sign was skin lesions. Anemia occurred in 87.5% (42/48) of the patients. The overall mortality rate was 16.7%. Low CD4 T-cell count and hemoglobin level were correlated with mortality. Based on these results, we concluded that penicilliosis should be considered in HIV-infected patients from eastern China who present with fever, cutaneous lesions, and anemia. The clinical characters and the prognosis of patients with penicilliosis are similar to those in endemic areas. More attention should be paid to penicilliosis patients with low CD4 T-cell count and/or low hemoglobin level.

Human Immuno-deficiency Virus (HIV) associated non-Hodgkin’s lymphoma (NHL) was a special group of disease, which manifests distinct clinical features and prognosis as compared with NHLs in patients without HIV. We performed this study to describe the clinical features of the disease and investigated the potential prognostic factors. HIV-infected patients who were newly diagnosed with NHL were enrolled in this study. The selection of anti-lymphoma treatment regimen was mainly dependent on the pathological subtypes of NHLs. Tumor response was reviewed and classified according to the International Workshop Criteria. A total of 78 patients were enrolled, among whom, 42 (53.8%) were with Diffuse large B cell Lymphoma (DLBCL), and 29 (37.2%) were with Burkitt lymphoma (BL). BL patients presented with higher risk features as compared with DLBCL in terms of numbers of extranodal diseases (P = 0.004) and poor Eastern cooperative oncology group (ECOG) score (P = 0.038). The estimated 2-year overall survival (OS) and progression free survival (PFS) rate was 74.3 ± 8.1%, 28.9 ± 11.0%, and 54.2 ± 8.1%, 19.2 ± 7.5% for DLBCL and BL, respectively. In multivariate analysis, international prognostic index (IPI) score was an independent prognostic factor for predicting both OS (OR = 2.172, 95% CI 1.579–2.987, P < 0.001) and PFS (OR = 1.838, 95% CI 1.406–2.402, P < 0.001). HIV associated NHLs represents a group of heterogeneous aggressive diseases with poor prognosis. IPI parameters were still effective in predicting the prognosis of HIV associated NHLs.