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DIAGNOSTIC VALUE OF URINE Mp1p FOR TALAROMYCOSIS IN HIV/AIDS PATIENTS
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Abstract
Background: Talromycosis is one of the most common opportunistic infections and a leading cause of death in HIV/AIDS patients in Vietnam. The main cause of this high mortality rate is relevant to late diagnosis due to the overlapping symptoms with other opportunistic infections as well as the delayed culture results, up to 14 days. Mp1p ELISA has been developed for early diagnosis talaromycosis. In addition to Mp1p serum detection, this antigen is also detected in urine, which can be useful to talaromycosis diagnosis, as well as reduction of the risk of occupational exposure of medical staffs.
Objectives: (1) To describe the distribution of urine Mp1p in HIV/AIDS patients with TCD4 count < 100 cells/mm3; (2) To determine cut-off value of urine Mp1p for Talaromycosis diagnosis in HIV/AIDS patients with TCD4 count < 100 cells/mm3; (3) To evaluate the agreement between urine and serum Mp1p in HIV/ AIDS patients with TCD4 count < 100 cells/mm3.
Subjects and method: A descriptive cross-sectional study. HIV-infected patients aged ≥ 18 years with TCD4+ < 100 cells/mm3 who were admitted to Ward E, Hospital for Tropical Diseases, from June 2017 to July 2019.
Results: There were 533 patients meeting the inclusion criteria; 70/533 was talaromycosis. The median of urine Mp1p in talaromycosis group was higher than the median of urine Mp1p in other opportunistic infections (3.15 (2.38 - 3.29) OD vs 0.02 (0.01 - 0.03) OD, p < 0,001) and higher than serum Mp1p in talaromycosis group (3.15 (2.38 - 3.29) vs OD 2.53 (0.76 - 3.01), p < 0.001)). The cut-off value of urine Mp1p was 0.60 OD, with SEN = 88.6% and SPE = 97%, respectively. Urine and serum Mp1p had a strong agreement with the kappa index (k-index) = 0.870, p = 0.001.
Conclusions: In addition to serum Mp1p ELISA, urine Mp1p ELISA is considered as a promising test for the early diagnosis of talaromycosis in AIDS patients.
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Keywords
HIV/AIDS, TCD4 , Talamomyces marneffei, urine Mp1p, cut-off value
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