Galactomannan test combined with CD4+T lymphocytes for the diagnosis of invasive aspergillosis in patients with AIDS

Abstract:

ObjectiveTo 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).Methods197 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.ResultsIn 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.ConclusionGM 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.