• Yuanyuan Qin, Yihong Zhou, Yanqiu Lu, Hui Chen, Zhongsheng Jiang, Kaiyin He, Qun Tian, Yingmei Qin, Man Rao, Vijay Harypursat, Huan Li, and Yaokai Chen.
• Clinical Research Center, Chongqing Public Health Medical Center, Shapingba, China.
• Mycoses. 2021 Feb 1; 64 (2): 203-211.

BackgroundAlthough the widespread use of modern antiretroviral therapy (ART) has reduced the incidence of talaromycosis in people living with HIV, mortality remains as high as 20% in this population, even after appropriate antifungal treatment.ObjectivesThe objective of our study was to develop a risk assessment system for HIV-infected patients with comorbid talaromycosis, in order to provide these patients with appropriate, effective and potentially life-saving interventions at an early stage of their illness.Patients/MethodsThis was a multicentre, retrospective cohort study conducted in China. We built a predictive model based on data from 11 hospitals, and a validated model using the data of 1 hospital located in an endemic area.ResultsForward stepwise multivariate statistical calculations indicated that age, aspartate aminotransferase/alanine transaminase ratio and albumin levels, and BUN levels were valid, independent predictors of the risk of death in HIV-infected patients with talaromycosis. Our developed and validated risk scoring system is effective for the identification of HIV-infected patients with talaromycosis at high risk of death at hospital admission (p < .001; AUC = 0.860). In our study, our risk prediction model provided functional and robust discrimination in the validation cohort (p < .001; AUC = 0.793).ConclusionThe prognostic scoring system for mortality assessment developed in the present study is an easy-to-use clinical tool designed to accurately assist clinicians in identifying high-risk patients with talaromycosis.© 2020 The Authors. Mycoses published by Wiley-VCH GmbH.

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