Identification of Clinical Characteristics and Risk Factors of Invasive Pulmonary Aspergillosis in Patients with Acquired Immunodeficiency Syndrome: A Retrospective Study

Weipeng Zhang,1 Yanrui Zhang,1 Yao Tang2 1Department of Pharmacy, The Eighth Hospital of Xi’an, Xi’an, Shaanxi, 710061, People’s Republic of China; 2Department of General Surgery, Xi’ an No. 3 Hospital, the Affiliated Hospital of Northwest University, Xi’ an, Shaanxi, 710018, People’s Republic of ChinaCorrespondence: Weipeng Zhang, Department of Pharmacy, The Eighth Hospital of Xi’an, Xi’an, Shaanxi, 710061, People’s Republic of China, Email [email protected]: Invasive pulmonary aspergillosis (IPA) is a severe opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS), characterized by nonspecific symptoms, delayed diagnosis, and high mortality. This study aimed to investigate the clinical characteristics and risk factors of IPA in AIDS patients.Patients and Methods: A retrospective analysis was conducted on 49 AIDS patients treated at the Xi’an Eighth Hospital between January 2022 and May 2024. The patients were divided into an IPA group (n=24) and a non-IPA group (n=25). The non-IPA group was used as the control group. Demographic information, medical records, laboratory features, and imaging findings were collected. The risk factors for IPA infection in AIDS patients were analyzed using multivariate logistic regression analysis.Results: Among AIDS patients with IPA, the predominant clinical manifestations included chest tightness, dyspnea, cough, expectoration, fatigue, and fever. The proportion of patients with a history of smoking and concomitant antibiotic use was higher in the IPA group than that in the control group. In contrast, the peripheral blood white cell (WBC) count, CD4+T lymphocyte count, and serum albumin (ALB) level were significantly lower in the IPA group than in the non-IPA group (P< 0.05). Multivariate logistic regression analysis identified concomitant use of antibiotics, reduced CD4+T lymphocyte count, and decreased ALB levels as independent risk factors for IPA in AIDS patients (P< 0.05).Conclusion: Concomitant use of antibiotics, reduced CD4+T lymphocyte count, and decreased ALB levels are independent risk factors for IPA in patients with AIDS. Early identification of these risk factors and timely initiation of appropriate clinical interventions are essential to reduce the incidence and improve the prognosis of IPA in AIDS patients.Keywords: AIDS, invasive pulmonary aspergillosis, risk factors, CD4+T lymphocyte