Characteristics and risk factors for readmission in HIV-infected patients with Talaromyces marneffei infection

Objectives Talaromyces marneffei ( T . marneffei ) is an opportunistic fungal infection (talaromycosis), which is common in subtropical regions and is a leading cause of death in HIV-1-infected patients. This study aimed to determine the characteristics and risk factors associated with hospital readmissions in HIV patients with T . marneffei infection in order to reduce readmissions. Methods We conducted a retrospective study of admitted HIV-infected individuals at the Fourth People’s Hospital of Nanning, Guangxi, China, from 2012 to 2019. Kaplan-Meier analyses and Principal component analysis (PCA) were used to evaluate the effects of T . marneffei infection on patient readmissions. Additionally, univariate and multifactorial analyses, as well as Propensity score matching (PSM) were used to analyze the factors associated with patient readmissions. Results HIV/AIDS patients with T . marneffei -infected had shorter intervals between admissions and longer lengths of stay than non- T . marneffei -infected patients, despite lower readmission rates. Compared with non- T. marneffei -infected patients, the mortality rate for talaromycosis patients was higher at the first admission. Among HIV/AIDS patients with opportunistic infections, the mortality rate was highest for T . marneffei at 16.2%, followed by cryptococcus at 12.5%. However, the readmission rate was highest for cryptococcus infection (37.5%) and lowest for T . marneffei (10.8%). PSM and Logistic regression analysis identified leukopenia and elevated low-density lipoprotein (LDL) as key factors in T.marneffei -infected patients hospital readmissions. Conclusions The first admission represents a critical window to intervene in the prognosis of patients with T . marneffei infection. Leukopenia and elevated LDL may be potential risk factors impacting readmissions. Our findings provide scientific evidence to improve the long-term outcomes of HIV patients with T . marneffei infection.