CT imaging and immune correlates in AIDS patients with pulmonary fungal infections

This study aimed to analyze the differences in pulmonary CT signs and peripheral blood T lymphocyte subset levels among acquired immune deficiency syndrome (AIDS) patients with different types of pulmonary fungal infections. Ninety-seven AIDS patients with single pulmonary fungal infections were divided into groups based on the type of fungal pathogen: Penicillium marneffei group (AIDS/P-T.M., n = 28), Candida group (AIDS/P-Can., n = 18), Cryptococcus group (AIDS/P-Cry., n = 20), and Aspergillus group (AIDS/P-Asp., n = 31). Clinical signs and pulmonary CT imaging data were collected. Peripheral blood was collected to measure viral load using fluorescence quantitative PCR, and T lymphocyte subsets were detected by flow cytometry. AIDS/P-T.M. group had higher rates of cough, fatigue, and skin lesions versus the other three groups ( p < 0.05). Pulmonary CT findings revealed that the rates of consolidation were higher in the AIDS/P-Cry. and AIDS/P-Can. groups than in the other two groups ( p < 0.05); the rate of pericardial effusion was higher in the AIDS/P-T.M. group than in the other three groups ( p < 0.05); the rate of cavities was higher in the AIDS/P-Cry. group than in the other three groups ( p < 0.05); and the rate of pleural thickening was markedly higher in the AIDS/P-Asp. group than in the other three groups ( p < 0.05). However, the AIDS/P-Asp. group exhibited higher CD4 + cell counts and CD4+/CD8+ ratios than the other three groups, while CD8 + cell counts were lower ( p < 0.05). CD4 + cell counts and CD4+/CD8+ ratios were negatively correlated with viral load across all four groups ( p < 0.05). AIDS patients with different fungal infections exhibit certain distinguishing CT features that can aid in differential diagnosis, although significant overlap in many radiological signs exists, but their viral load levels are consistently negatively correlated with CD4 + counts. Immunodeficiency degree is the fundamental factor determining viral replication and infection risk.