@article{10.37349/emed.2025.1001363,
abstract = {Aim: Because of severe immunosuppression, coinfections continue to be a major cause of morbidity and mortality in HIV-infected patients. As the primary method currently used for diagnosing coinfections in HIV-infected patients, conventional microbiological tests (CMTs) often suffer from limitations such as prolonged processing times and low sensitivity, which may delay the initiation of appropriate treatment. This retrospective study aims to explore the applicability of metagenomic next-generation sequencing (mNGS) as a diagnostic tool compared with CMT. Methods: A retrospective study was conducted on HIV-infected patients with coinfections admitted to Peking Union Medical College Hospital between November 2022 and November 2024. A receiver operating characteristic (ROC) curve was generated to evaluate the predictors and determine their sensitivities and specificities. The comprehensive final clinical diagnosis (FCD) was used as the reference standard for evaluating the diagnostic performance of CMT and mNGS. Then, treatment adjustments and outcomes after mNGS and CMT of the HIV-infected patients were also assessed. Results: The areas under the ROC curve (AUCs) for CMT and mNGS were 0.600 and 0.775, respectively. When mNGS was combined with CMT, the AUC was 0.833. The sensitivity and specificity of mNGS were 80% and 75%, whereas those of CMT were 20% and 100%. When mNGS was combined with CMT, the sensitivity increased to 86.67%. Among the 15 coinfected HIV patients, 8 patients underwent treatment adjustments on the basis of mNGS results and achieved effective treatment, whereas only 1 patient underwent treatment adjustments solely on the basis of CMT and achieved effective treatment. Conclusions: Compared with CMT, mNGS has a better detection rate. mNGS provides an alternative and promising method for identifying coinfections in HIV-positive patients. Thus, the combination of mNGS and CMT is a better diagnostic strategy for coinfections in HIV patients.},
author = {Yan, Yun-Meng and Zhang, Dong and Du, Juan and Gao, Yi and Wang, Yao and Lu, Min-Ya and Guo, Jia-Yu and Su, Hui-Ting and Chen, Xin-Fei and Xu, Ying-Chun and Yang, Qi-Wen},
doi = {10.37349/emed.2025.1001363},
journal = {Exploration of Medicine},
elocation-id = {1001363},
title = {Enhancing the precision diagnosis and treatment of HIV-related coinfections through metagenomic next-generation sequencing},
url = {https://www.explorationpub.com/Journals/em/Article/1001363},
volume = {6},
year = {2025}
}