Galactomannan test combined with CD4+T lymphocytes for the diagnosis of invasive aspergillosis in patients with AIDS / 中国感染控制杂志

ABSTRACT

Objective To evaluate the effect of galactomannan(GM) test combined with CD4+ T lymphocyte detection on early diagnosis of invasive aspergillosis (IA) in patients with acquired immunodeficiency syndrome (AIDS).Methods 197 AIDS patients who were suspected with IA in a hospital from January 2014 to December 2016 were analyzed retrospectively,they were divided into confirmed IA group (n =35),clinically diagnosed IA group (n=96,suspected cases),and non-IA group(n =66),sensitivity and specificity of GM test and GM test combined CD4+ T lymphocyte counting for diagnosing IA were compared.Results In confirmed IA group,clinically diagnosed IA group,and non-IA group,the medium values of GM (minimum,maximum) were 1.29(0.65,1.84)pg /mL,0.91(0.36,1.23)pg /mL,and 0.11(0.28,0.72)pg /mL respectively,CD4+ T lymphocyte counting were 45 (29,69)cells/μL,79(35,99) cells/μL,and 89 (59,158) cells/μL respectively,GM value and CD4+ T lymphocyte counting among three groups were significantly different(all P＜0.05).The sensitivity and specificity of single GM test for diagnosing IA in AIDS patients were 64.9％ and 72.7％ respectively;sensitivity and specificity of two consecutive GM test within one week for diagnosing IA were 72.5 ％ and 95.5 ％ respectively;sensitivity and specificity of GM test combined CD4+ T lymphocyte counting were 86.3％ and 90.9％ respectively.Conclusion GM test has better diagnostic value for IA in AIDS patients,continuous GM test and GM test combined CD4+ T lymphocyte counting will further improve the clinical diagnostic value for IA.