Abstract: Objective To explore the relationship between the count of CD4⁺T lymphocyte and the chest CT features including manifestation, distributions of pulmonary lesion, as well as the severity of pulmonary lesion in AIDS patients with Talaromycosis (TSM). Method A retrospective analysis was performed on the clinical data, chest CT findings and CD4⁺T lymphocyte counts of 122 patients with AIDS complicated by TSM who were admitted to Shanghai Public Health Clinical Center from January 2015 to December 2024. The relationships between CT imaging manifestations/distribution characteristics of pulmonary lesions and CD4⁺T lymphocyte counts were investigated. The correlations between the number of affected pulmonary segments/CT severity scores and CD4⁺T lymphocyte counts were analyzed. Result The chest CT manifestations of AIDS patients with TSM were diverse, mainly including miliary nodule, nodule, ground-glass opacity or patchy shadow, and mediastinal lymphadenopathy. There were no significant differences in CD4⁺T lymphocyte count among groups with different chest CT manifestations (P>0.05), including between groups with miliary nodule and those without, groups with mediastinal lymphadenopathy and those without, and groups with pulmonary lesion and those without. There were no significant differences in CD4⁺T lymphocyte count among groups with different distributions of pulmonary lesion (P>0.05), including between groups with bilateral distribution and non-bilateral distribution, and between groups with diffuse distribution and non-diffuse distribution. The number of lung segment involved by pulmonary lesion and the CT score of pulmonary lesion showed no significant correlation with CD4⁺T lymphocyte count (P>0.05). Conclusion This study demonstrates that the pulmonary CT manifestations (including lesion morphology and distribution) and their severity in AIDS patients with Talaromyces marneffei infection show no significant correlation with CD4⁺T lymphocyte counts. These findings suggest that the imaging characteristics of Talaromyces marneffei infection may be independent of the degree of host immunosuppression, providing a new perspective for understanding the pathogenesis of this disease.

Key words: Acquired immune deficiency syndrome, Talaromyces marneffei, CD4⁺T lymphocyte, Tomography