Metagenomic Next-generation Nequencing Aids the Diagnosis of Co-infection In HIV-infected Patients

Abstract Background HIV-infected patients are easy to combine with various opportunistic infections due to their low immunity. Improving microbiological diagnosis in these patients is of paramount clinical importance. Methods Thirty-six HIV-infected patients with suspected infection were retrospectively reviewed from April 2018 to December 2019. The diagnostic performance of pathogens was compared between traditional microbiological methodology and mNGS. Results The sensitivity of mNGS for diagnosing infectious disease was outperformed of culture, especially for virus (mNGS only; P < 0.001), fungus (odds ratio [OR], 1.1[95% confidence interval {CI}, 0.9–1.5]; P < 0.05), parasite (mNGS only; P < 0.01) and Mycobacterium tuberculosis (OR, 1.7 [95% CI, 1.0 − 2.8]; P < 0.05). Moreover, for mNGS-positive cases where the conventional method was inconclusive, 27 (69.2%) cases led to diagnosis modification. Conclusions mNGS was more sensitive and comprehensive for pathogen identification therefore a promising method for microbiological diagnosis in AIDS patients with infection.