Analysis of Clinical Characteristics in AIDS Patients Complicated by Pulmonary Aspergillosis

Next-generation sequencing (NGS) showed the highest pathogen detection rate (75.9%), with Aspergillus fumigatus (48.3%) being the predominant pathogen. Twenty-two patients (75.9%) had concurrent fungal infections other than aspergillosis. After PA diagnosis, all patients received antifungal therapy, including 21 (72.4%) treated with voriconazole.

Twenty-seven patients (93.1%) showed clinical improvement after treatment. At discharge, 25 patients (86.2%) continued antifungal therapy, of whom 17 (68.0%) received voriconazole. Compared with the CPA/ABPA group, the IPA group had significantly lower rates of antiretroviral therapy (9.1% vs. 57.1%, P < 0.05) and HIV viral suppression (0 vs. 71.4%, P < 0.05), as well as higher proportions of CD4+ T lymphocyte counts < 200 cells/μL (95.5% vs. 28.6%, P < 0.05) and fatigue symptoms (40.9% vs. 14.3%, P < 0.05).

No significant differences were observed in other indicators (P > 0.05). Conclusion PA in AIDS patients is predominantly IPA, which mainly occurs in untreated advanced patients with severe immunodeficiency, whereas CPA/ABPA is more common in immunocompetent or mildly compromised patients. NGS demonstrates high diagnostic value for PA, with A. fumigatus being the primary pathogen. Treatment with voriconazole is beneficial for improving patients' conditions.