{ "abstract": "Background: Talaromycosis (TSM) is a severe opportunistic fungal infection that mostly infects patients with acquired immunodeficiency syndrome (AIDS). After antiretroviral therapy (ART), AIDS patients with TSM may develop immune reconstitution inflammatory syndrome (IRIS), leading to the paradoxical worsening of clinical symptoms. However, the immunological characteristics of TSM-related IRIS (TSM-IRIS) in AIDS patients remain poorly understood. Methodology/Principal Findings: We conducted a longitudinal cohort study of AIDS patients with TSM and analyzed the immunological features using flow cytometry, transcriptome, and multiplex cytokine assays at admission, ART initiation, and at 2, 4 weeks after ART initiation. Patients with TSM-IRIS displayed significantly higher baseline CD3 ⁺ T cells at admission and lower frequencies of PD-1 ⁺ CD4 ⁺ T cells at ART initiation than those without IRIS (non-IRIS). After ART initiation, TSM-IRIS was associated with dynamic transcriptomic changes involving inflammatory and immune-related pathway enrichment, along with sustained elevations of interleukin (IL)-17, IL-21, C-X-C motif chemokine ligand (CXCL) 5, and CXCL12. Transcriptomic analysis revealed the dynamic enrichment of pro-inflammatory pathways prior to and during the early phase of ART. Conclusion/Significance: AIDS patients with TSM-IRIS exhibited an immune profile associated with enhanced T cell activation, characterized by accelerated immune reconstitution accompanied by heightened inflammatory activity during the early phase of ART, may potentially acting as the immune markers for prediction or diagnosis of TSM-IRIS in AIDS patients. Author summary: For patients with acquired immunodeficiency syndrome (AIDS), initiating antiretroviral therapy (ART) typically restores immune function and improves clinical outcomes. However, following ART initiation, restored immunity to specific infectious or non-infectious antigens may result in paradoxical clinical worsening or new disease. In this study, we monitored and compared immunological features in AIDS patients with talaromycosis (TSM) who developed immune reconstitution inflammatory syndrome (IRIS) with those without IRIS during ART treatment. We found that patients with TSM-IRIS exhibited an earlier rise in CD3+ T cells at admission and lower frequencies of PD-1+ CD4+ T cells at ART initiation than patients without IRIS. Overall, our study described the accelerated immune reconstitution accompanied by heightened inflammatory activity in TSM-IRIS, a phenomenon with limited prior evidence.", "abstract_shown": true, "affiliations": [ "Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, China", "Guangzhou Medical Research Institute of Infectious Diseases, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, China", "Infectious Diseases Department, Foshan First People’s Hospital, Foshan, China" ], "article_type": "Research Article", "arxiv": null, "author_total": 11, "authors": [ { "affs": [ 0 ], "name": "Bei Zhao" }, { "affs": [ 1 ], "name": "Qinzhi Zhang" }, { "affs": [ 2 ], "name": "Pengle Guo" }, { "name": "Yingyin Yang" }, { "name": "Feilong Xu" }, { "name": "Xuemei Ling" }, { "name": "Kaiyin He" }, { "name": "Xiejie Chen" }, { "name": "Xiaoping Tang" }, { "name": "Huihua Zhang" }, { "name": "Linghua Li" } ], "bibtex": "https://research.draconitic.com/paper/3vsdksra95aw3.bib", "cited_by": 0, "doi": "10.1371/journal.pntd.0014695", "fulltext_url": "https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014695", "id": "3vsdksra95aw3", "issns": [ "1935-2735" ], "landing_url": "https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014695", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2746|Infectious Diseases and Tuberculosis" ], [ "plos", "/Biology and life sciences/Cell biology/Cell motility/Chemotaxis/Chemokines" ], [ "plos", "/Biology and life sciences/Cell biology/Cellular types/Animal cells/Blood cells/White blood cells/Monocytes" ], [ "plos", "/Biology and life sciences/Cell biology/Cellular types/Animal cells/Blood cells/White blood cells/T cells/Cytotoxic T cells" ], [ "plos", "/Biology and life sciences/Cell biology/Cellular types/Animal cells/Blood cells/White blood cells/T helper cells" ], [ "plos", "/Biology and life sciences/Cell biology/Cellular types/Animal cells/Immune cells/White blood cells/Monocytes" ], [ "plos", "/Biology and life sciences/Cell biology/Cellular types/Animal cells/Immune cells/White blood cells/T cells/Cytotoxic T cells" ], [ "plos", "/Biology and life sciences/Cell biology/Cellular types/Animal cells/Immune cells/White blood cells/T helper cells" ], [ "plos", "/Biology and life sciences/Developmental biology/Molecular development/Cytokines" ], [ "plos", "/Biology and life sciences/Immunology/Immune cells/White blood cells/Monocytes" ], [ "plos", "/Biology and life sciences/Immunology/Immune cells/White blood cells/T cells/Cytotoxic T cells" ], [ "plos", "/Biology and life sciences/Immunology/Immune cells/White blood cells/T helper cells" ], [ "plos", "/Biology and life sciences/Immunology/Immune response/Inflammation" ], [ "plos", "/Biology and life sciences/Immunology/Immune system/Innate immune system/Cytokines" ], [ "plos", "/Biology and life sciences/Immunology/Vaccination and immunization/Antiviral therapy/Antiretroviral therapy" ], [ "plos", "/Biology and life sciences/Physiology/Immune physiology/Cytokines" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Inflammation" ], [ "plos", "/Medicine and health sciences/Immunology/Immune cells/White blood cells/Monocytes" ], [ "plos", "/Medicine and health sciences/Immunology/Immune cells/White blood cells/T cells/Cytotoxic T cells" ], [ "plos", "/Medicine and health sciences/Immunology/Immune cells/White blood cells/T helper cells" ], [ "plos", "/Medicine and health sciences/Immunology/Immune response/Inflammation" ], [ "plos", "/Medicine and health sciences/Immunology/Immune system/Innate immune system/Cytokines" ], [ "plos", "/Medicine and health sciences/Immunology/Vaccination and immunization/Antiviral therapy/Antiretroviral therapy" ], [ "plos", "/Medicine and health sciences/Medical conditions/Infectious diseases/Opportunistic infections" ], [ "plos", "/Medicine and health sciences/Public and occupational health/Preventive medicine/Vaccination and immunization/Antiviral therapy/Antiretroviral therapy" ] ], "openalex": "W7204871538", "pdf_url": "https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0014695&type=printable", "pmcid": null, "pmid": null, "published": "2026-09-01", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/3vsdksra95aw3.ris", "sources": [ { "first_seen": "2026-10-30T12:18:02Z", "native_id": "10.1371/journal.pntd.0014695", "source": "plos", "url": "https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014695" } ], "subjects": [ { "field": "biology", "origin": "plos:cell biology", "subfield": "cell-biology" }, { "field": "biology", "origin": "plos:immunology", "subfield": "immunology" } ], "title": "Talaromycosis-associated immune reconstitution inflammatory syndrome exhibits immune dysregulation in patients with acquired immunodeficiency syndrome", "title_text": "Talaromycosis-associated immune reconstitution inflammatory syndrome exhibits immune dysregulation in patients with acquired immunodeficiency syndrome", "type": "peer-reviewed", "updated_at": "2026-10-30T12:18:02Z", "url": "https://research.draconitic.com/paper/3vsdksra95aw3", "venue": "PLOS Neglected Tropical Diseases", "versions": [] }