Hematological toxicity of amphotericin B deoxycholate-based induction therapy in patients with HIV-associated talaromycosis

Abstract

Abstract Background: This study's objective was to investigate the predictors for severe anemia, severe leukopenia, and severe thrombocytopenia when amphotericin B deoxycholate-based induction therapy is used in HIV patients with talaromycosis. Methods: A total of 170 HIV patients with talaromycosis were enrolled from January 1st, 2019 to September 30th, 2020. Results: Approximately 42.9%, 20.6%, and 10.6% of the enrolled patients developed severe anemia, severe leukopenia and severe thrombocytopenia, respectively. Baseline lower hemoglobin levels, higher serum creatinine levels, higher AST/ALT ratios, lower sodium levels, and higher administered doses of amphotericin B were observed to be independent risk factors associated with the development of severe anemia. Co-infection with tuberculosis and lower platelet levels at baseline were shown to be independent risk factors associated with the development of severe leukopenia. A lower platelet level at baseline was the independent risk factor found to be associated with the development of severe thrombocytopenia. Conclusion: The preceding findings reveal risk factors for severe anemia, severe leukopenia, and severe thrombocytopenia, which will favor prevention and timely treatment of hematological toxicity, improvement of patient’s outcomes, shorter hospital stays, and a reduction of the requirement for blood transfusion.