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Etiologies of fever of unknown origin in HIV/AIDS patients, Hanoi, Vietnam
BACKGROUND: Fever of unknown origin (FUO) is a challenge for clinicians treating patients with HIV/AIDS. CD4 counts can be helpful in the diagnosis and treatment. This study aimed to determine several common etiologies of FUO stratified by CD4 count levels in HIV/AIDS patients. METHODS: A cross-sect...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8764815/ https://www.ncbi.nlm.nih.gov/pubmed/35042469 http://dx.doi.org/10.1186/s12879-022-07049-3 |
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author | Nguyen, Thu Kim Nguyen, Yen Hai Nguyen, Hao Thi Khong, Quang Minh Tran, Ngoc Kim |
author_facet | Nguyen, Thu Kim Nguyen, Yen Hai Nguyen, Hao Thi Khong, Quang Minh Tran, Ngoc Kim |
author_sort | Nguyen, Thu Kim |
collection | PubMed |
description | BACKGROUND: Fever of unknown origin (FUO) is a challenge for clinicians treating patients with HIV/AIDS. CD4 counts can be helpful in the diagnosis and treatment. This study aimed to determine several common etiologies of FUO stratified by CD4 count levels in HIV/AIDS patients. METHODS: A cross-sectional retrospective and prospective study was conducted in 195 HIV/AIDS patients with FUO admitted to the National Hospital for Tropical Diseases from January 2016 to June 2019. Clinical parameters, immune status, and etiologies for each patient were recorded. Odds ratios were calculated to compare the distributions of common etiologies in groups with two different CD4 count levels: < 50 cells/mm(3) and ≥ 50 cells/mm(3). RESULTS: The proportions of opportunistic infections and noninfectious etiologies were 93.3% and 3.6%, respectively. Tuberculosis was the most common opportunistic infection (46.7%), followed by talaromycosis (29.2%) and Pneumocystis jiroveci (PCP) infection (20.5%). Tuberculosis was predominant in all CD4 level groups. Most patients with talaromycosis had CD4 counts below 50 cells/mm(3). In total, 53.8% of the patients were infected by one pathogen. The risks of tuberculosis and talaromycosis in FUO-HIV patients were high when their CD4 counts were below 50 cells/mm(3). CONCLUSIONS: Opportunistic infections, especially tuberculosis, are still the leading cause of FUO in HIV/AIDS patients. Tuberculosis and Talaromyces marneffei (TM) infection should be considered in patients with CD4 cell counts < 50 cells/mm(3). This study implies that guidelines for appropriate testing to identify the etiology of FUO in HIV/AIDS patient based on the CD4 cell count should be developed, thereby reducing resource waste. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-022-07049-3. |
format | Online Article Text |
id | pubmed-8764815 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87648152022-01-18 Etiologies of fever of unknown origin in HIV/AIDS patients, Hanoi, Vietnam Nguyen, Thu Kim Nguyen, Yen Hai Nguyen, Hao Thi Khong, Quang Minh Tran, Ngoc Kim BMC Infect Dis Research BACKGROUND: Fever of unknown origin (FUO) is a challenge for clinicians treating patients with HIV/AIDS. CD4 counts can be helpful in the diagnosis and treatment. This study aimed to determine several common etiologies of FUO stratified by CD4 count levels in HIV/AIDS patients. METHODS: A cross-sectional retrospective and prospective study was conducted in 195 HIV/AIDS patients with FUO admitted to the National Hospital for Tropical Diseases from January 2016 to June 2019. Clinical parameters, immune status, and etiologies for each patient were recorded. Odds ratios were calculated to compare the distributions of common etiologies in groups with two different CD4 count levels: < 50 cells/mm(3) and ≥ 50 cells/mm(3). RESULTS: The proportions of opportunistic infections and noninfectious etiologies were 93.3% and 3.6%, respectively. Tuberculosis was the most common opportunistic infection (46.7%), followed by talaromycosis (29.2%) and Pneumocystis jiroveci (PCP) infection (20.5%). Tuberculosis was predominant in all CD4 level groups. Most patients with talaromycosis had CD4 counts below 50 cells/mm(3). In total, 53.8% of the patients were infected by one pathogen. The risks of tuberculosis and talaromycosis in FUO-HIV patients were high when their CD4 counts were below 50 cells/mm(3). CONCLUSIONS: Opportunistic infections, especially tuberculosis, are still the leading cause of FUO in HIV/AIDS patients. Tuberculosis and Talaromyces marneffei (TM) infection should be considered in patients with CD4 cell counts < 50 cells/mm(3). This study implies that guidelines for appropriate testing to identify the etiology of FUO in HIV/AIDS patient based on the CD4 cell count should be developed, thereby reducing resource waste. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-022-07049-3. BioMed Central 2022-01-18 /pmc/articles/PMC8764815/ /pubmed/35042469 http://dx.doi.org/10.1186/s12879-022-07049-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Nguyen, Thu Kim Nguyen, Yen Hai Nguyen, Hao Thi Khong, Quang Minh Tran, Ngoc Kim Etiologies of fever of unknown origin in HIV/AIDS patients, Hanoi, Vietnam |
title | Etiologies of fever of unknown origin in HIV/AIDS patients, Hanoi, Vietnam |
title_full | Etiologies of fever of unknown origin in HIV/AIDS patients, Hanoi, Vietnam |
title_fullStr | Etiologies of fever of unknown origin in HIV/AIDS patients, Hanoi, Vietnam |
title_full_unstemmed | Etiologies of fever of unknown origin in HIV/AIDS patients, Hanoi, Vietnam |
title_short | Etiologies of fever of unknown origin in HIV/AIDS patients, Hanoi, Vietnam |
title_sort | etiologies of fever of unknown origin in hiv/aids patients, hanoi, vietnam |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8764815/ https://www.ncbi.nlm.nih.gov/pubmed/35042469 http://dx.doi.org/10.1186/s12879-022-07049-3 |
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