To study the diagnostic value of G test and fungal culture method for HIV infection patients/AIDS patients (HIV/AIDS) with invasive fungal infection.

In our hospital from June 2015 to May 2016, total of 1 423 patients with HIV/AIDS who were admitted to the hospital. In pumping blood to do(1, 3)-β-D-glucan detection at the same time, take blood or bone marrow, sputum, lavage fluid, throat swab, cerebrospinal fluid, feces and other specimens for fungal culture. Through retrospective survey, the clinical symptoms of patients after the use of anti-fungal drugs to ease as a clinical diagnostic criteria, and as a standard to compare the differences between the two detection methods.

Among the 1 423 patients, 588 patients were treated with anti-fungal drugs, and patients were treated as invasive fungal infection (IFI) group, while 835 cases of symptom remission after anti-fungal therapy were collected as non-IFI group. When the critical value of 100.5 pg/ml was positive, G test was positive in 527 cases, negative in 896 cases, the accuracy was 91.36%, and the accuracy of 90.5 pg/ml, 110.5 pg/ml and 120.5 pg/ml were 89.88%, 90.51% and 89.18%, respectively. Fungal culture was positive in 636 cases and negative in 787 cases. The content of G in the IFI group and non-IFI group were (532.83 ± 778.67) pg/ml, with the significant difference (t = 15.208, P < 0.001). In the IFI group, Candida infection group, Penicillium marneffei infection group, cryptococcal infection group, Candida albicans and Penicillium marneffei mixed infection group G test were (444.29 ± 705.44) pg/ml, (452.78 ± 511.40) pg/ml, (89.56 ± 71.58) pg/ml and (596.28 ± 840.23) pg/ml. G test content of cryptococcal infection with Candida infection (t = 6.581, P < 0.001), Penicillium marneffei infection (t = 6.889, P < 0.001) and Candida and Penicillium marneffei co-infection (t = 4.865, P < 0.001), with significant differences. The sensitivity of G test and fungal culture method were 84.35% and 70.75%, with significant differences (χ² = 5.331, P = 0.021). The specificity of G test and fungal culture method were 96.29% and 73.65%, with significant differences (χ² = 20.067, P < 0.001). The two method combined detection sensitivity was 96.43%, and the specificity was 70.54%.

In patients with HIV/AIDS diagnosis of IFI G test fungal culture method was simple, rapid, high positive rate and high specificity. Continuous monitoring of G test was helpful to improve the diagnostic efficiency of IFI; the combined detection could improve the diagnosis efficiency of Pneumocystis and Cryptococcus, early prediction and diagnosis of Penicillium marneffei infection.