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High titers of anti-interferon-γ autoantibodies (AIGAs) are an important factor leading to persistent, relapsed, and refractory infections in HIV-negative hosts infected with Talaromyces marneffei (TM). We report 5 patients treated with pulses of high-dose intravenous cyclophosphamide (IVCY) who were followed for 2 years. Before IVCY therapy, all patients had multiple relapses, with a median (interquartile range [IQR]) of 2 (1–3) instances of relapse. The median serum AIGA titers (IQR) were 58 753 (41 203–89 605) ng/mL at diagnosis, 48 189.4 (15 537–83 375) ng/mL before IVCY therapy, and 10 721.2 (5637–13 245) ng/mL at the end of IVCY therapy (P <.05). After 3 months of follow-up, the median AIGA titers (IQR) rose gradually to 21 232.6 (9896–45 626) ng/mL, and to 37 464.2 (19 872–58 321) ng/mL at 24 months (P <.05). Five patients discontinued antimicrobial therapy within 3–12 months after completion of IVCY therapy, but only 1 patient had a relapse. In conclusion, pulses of short-term and high-dose IVCY can effectively reduce AIGA titers. [ABSTRACT FROM AUTHOR]

A high titer of neutralizing anti-interferon-γ autoantibodies can cause immunodeficiency associated with severe or disseminated infections caused by Talaromyces marneffei in human immunodeficiency virus-negative patients. Herein, we reported a rare case of disseminated Talaromyces marneffei and Burkholderia cepacia infection. The patient's lungs, lymph nodes, and bronchi were involved, and he had neck abscesses and osteomyelitis. We measured the neutralizing anti-interferon-γ autoantibodies in the peripheral blood and found that the patient had a persistently high positive titer. Despite aggressive treatment, the patient developed disseminated intravascular coagulation and died. Thus, high-titer nAIGAs may be associated with multiple opportunistic, persistent and disseminated infections. [ABSTRACT FROM AUTHOR]