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Administration of Voriconazole in Disseminated Talaromyces (Penicillium) Marneffei Infection: A Retrospective Study

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Abstract

Talaromyces (Penicillium) marneffei infection is a fatal disseminated mycosis caused by the dimorphic fungus Talaromyces marneffei; the therapeutic strategies for this infectious disease are limited. The aim of this retrospective study was to evaluate the efficacy and safety of voriconazole for treating patients with disseminated T. marneffei infection with or without HIV infection in a clinical setting. Patients who intravenously received voriconazole (6 mg/kg q12 h for the first 24 h followed by 4 mg/kg q12 h) as the initial antifungal treatment were enrolled. The duration of the following antifungal treatment varied at the discretion of the investigators according to the patient responses. The primary global response was evaluated at Week 16 or at the end of treatment (EOT). Follow-up evaluations were performed at 6 months and 1 year after the EOT. Seventeen patients were enrolled in this study, but three were not evaluable because the treatment was prematurely discontinued. Among the remaining fourteen patients, ten patients had complete response and three had partial response at Week 16. Only one patient was determined to have failed response. Follow-up assessments in eleven patients showed that eight patients were cured and the remaining three patients relapsed at 6 months after the EOT. These eight patients were assessed 1 year later, and none of them had relapsed. No adverse events associated with voriconazole were recorded during the treatment. The results from our study suggest that voriconazole is an effective, well-tolerated therapeutic option for disseminated T. marneffei infection.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (Nos. 81571971, 81060128 and 81271804), Natural Science Foundation of Guangxi Province of China (Nos. 0991144 and 2012jjAA40175), a Guangxi Key Laboratory of AIDS Prevention and Treatment. The funders have no role in study design, data, collection and analysis, decision to publish, or preparation of the manuscript.

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    Authors and Affiliations

    1. Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China

      Yanyin Ouyang & Cunwei Cao

    2. Department of Respiratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China

      Shuangqi Cai

    3. Center for AIDS Research & School of Public Health, Guangxi Medical University, Nanning, 530021, China

      Hao Liang

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    1. Yanyin Ouyang
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    2. Shuangqi Cai
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    3. Hao Liang
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    4. Cunwei Cao
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    Correspondence to Cunwei Cao.

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    Yanyin Ouyang, Shuangqi Cai have contributed equally to this work.

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    Ouyang, Y., Cai, S., Liang, H. et al. Administration of Voriconazole in Disseminated Talaromyces (Penicillium) Marneffei Infection: A Retrospective Study. Mycopathologia 182, 569–575 (2017). https://doi.org/10.1007/s11046-016-0107-3

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