Journal of infection and public health · 2025
Clinical characteristics analysis of anti-interferon-γ autoantibodies-associated adult-onset immunodeficiency with mycobacterium tuberculosis infection.
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Huang Xuemei, Wu Siyao, Zeng Qiangxiu, Liang Siqiao, Liang Hanlin, Wang Mengchan, Hong Limei, Liang Xiaona, Chen Ni, Ning Yan, Pang Haiyan, Zhang Ziyi, Nong Ying, Yan Ping, He Zhiyi
Аннотация
BACKGROUND: Anti-interferon-γ autoantibodies (AIGAs) syndrome is a rare adult-onset immunodeficiency (AOID) syndrome with multiple opportunistic infections. However, its clinical characteristics in Mycobacterium tuberculosis (MTB) infection remain unclear.
METHODS: A prospective cohort study of adult patients with opportunistic infections was conducted from January 2021 to January 2025 in Guangxi, southern China. MTB-infected patients were divided into AIGAs-positive and AIGAs-negative groups, and their clinical and laboratory data were compared. Additionally, the AIGAs-positive group was divided into subgroups (with or without nontuberculous mycobacteria (NTM) or Talaromyces marneffei (TM) co-infection) for detailed analysis.
RESULTS: Among over 400 patients recruited, 48 of the 86 with MTB infection were AIGAs-positive (Group 1), and 38 were AIGAs-negative (Group 2). Group 1 patients commonly show involvement of the lungs, lymph nodes, bones, and skin, with often multi-organ involvement. Disseminated infections are more prevalent in Group 1, often accompanied by TM/NTM infections. They also show elevated white blood cell count, neutrophils, monocytes, C-reactive protein, erythrocyte sedimentation rate, globulin, and immunoglobulin G levels (P < 0.05). During an average follow-up of 19 months, 50.00 % of patients experienced acute exacerbations, of which 82.61 % were caused by new pathogen infections. Multivariable Cox regression analysis indicated that splenic involvement, elevated serum G test levels, and NTM infection were risk factors for disease progression (P < 0.05). The TM/NTM co-infected subgroup had higher acute exacerbation rates, AIGAs titers, inflammatory/immune markers, and more organ involvement.
CONCLUSIONS: Patients with AIGAs-related AOID and MTB infection had high infection markers, immune issues, and multi-organ involvement, which worsened with TM/NTM co-infection.
METHODS: A prospective cohort study of adult patients with opportunistic infections was conducted from January 2021 to January 2025 in Guangxi, southern China. MTB-infected patients were divided into AIGAs-positive and AIGAs-negative groups, and their clinical and laboratory data were compared. Additionally, the AIGAs-positive group was divided into subgroups (with or without nontuberculous mycobacteria (NTM) or Talaromyces marneffei (TM) co-infection) for detailed analysis.
RESULTS: Among over 400 patients recruited, 48 of the 86 with MTB infection were AIGAs-positive (Group 1), and 38 were AIGAs-negative (Group 2). Group 1 patients commonly show involvement of the lungs, lymph nodes, bones, and skin, with often multi-organ involvement. Disseminated infections are more prevalent in Group 1, often accompanied by TM/NTM infections. They also show elevated white blood cell count, neutrophils, monocytes, C-reactive protein, erythrocyte sedimentation rate, globulin, and immunoglobulin G levels (P < 0.05). During an average follow-up of 19 months, 50.00 % of patients experienced acute exacerbations, of which 82.61 % were caused by new pathogen infections. Multivariable Cox regression analysis indicated that splenic involvement, elevated serum G test levels, and NTM infection were risk factors for disease progression (P < 0.05). The TM/NTM co-infected subgroup had higher acute exacerbation rates, AIGAs titers, inflammatory/immune markers, and more organ involvement.
CONCLUSIONS: Patients with AIGAs-related AOID and MTB infection had high infection markers, immune issues, and multi-organ involvement, which worsened with TM/NTM co-infection.