Central nervous system toxoplasmosis in HIV pathogenesis, diagnosis, and therapy

Luft, Benjamin J.; Chua, A.T.

doi:10.1007/s11908-000-0016-x

Cited by 48 publications

(34 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Earlier studies showed that different levels of anti-T. gondii IgG antibodies were unable to determine a reactivation or to follow the course of cerebral toxoplasmosis (26,27,34). However, others have suggested that high titers in patients might be indicative of the presence of cerebral toxoplasmosis or a higher risk of developing the disease (13,18).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis of Cerebral Toxoplasmosis in AIDS Patients in Brazil: Importance of Molecular and Immunological Methods Using Peripheral Blood Samples

Vidal²,

et al. 2005

View full text Add to dashboard Cite

Cerebral toxoplasmosis is the most common cerebral focal lesion in AIDS and still accounts for high morbidity and mortality in Brazil. Its occurrence is more frequent in patients with low CD4 ؉ T-cell counts. It is directly related to the prevalence of anti-Toxoplasma gondii antibodies in the population. Therefore, it is important to evaluate sensitive, less invasive, and rapid diagnostic tests. We evaluated the value of PCR using peripheral blood samples on the diagnosis of cerebral toxoplasmosis and whether its association with immunological assays can contribute to a timely diagnosis. We prospectively analyzed blood samples from 192 AIDS patients divided into two groups. The first group was composed of samples from 64 patients with cerebral toxoplasmosis diagnosed by clinical and radiological features. The second group was composed of samples from 128 patients with other opportunistic diseases. Blood collection from patients with cerebral toxoplasmosis was done before or on the third day of anti-toxoplasma therapy. PCR for T. gondii, indirect immunofluorescence, enzyme-linked immunosorbent assay, and an avidity test for toxoplasmosis were performed on all samples. The PCR sensitivity and specificity for diagnosis of cerebral toxoplasmosis in blood were 80% and 98%, respectively. Patients with cerebral toxoplasmosis (89%) presented higher titers of anti-T. gondii IgG antibodies than patients with other diseases (57%) (P < 0.001). These findings suggest the clinical value of the use of both PCR and high titers of anti-T. gondii IgG antibodies for the diagnosis of cerebral toxoplasmosis. This strategy may prevent more invasive approaches.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Cerebral toxoplasmosis is one of the most common opportunistic neurological infections in AIDS patients, and it is typically observed in the later stages of human immunodeficiency virus (HIV) infection (26). It is also directly related to the prevalence of anti-T. gondii antibodies in the general population (21).…”

mentioning

confidence: 99%

Diagnosis of Cerebral Toxoplasmosis in AIDS Patients in Brazil: Importance of Molecular and Immunological Methods Using Peripheral Blood Samples

Vidal²,

et al. 2005

View full text Add to dashboard Cite

show abstract

“…3 Cerebral toxoplasmosis is typically observed in the later stages of HIV infection. 4,5,6 CNS disease occurs when, CD4 counts are <200 cells/μL. The greatest risk is in patients with CD4 counts <50 cells/μL.…”

mentioning

confidence: 99%

Clinical Profile of Cerebral Toxoplasmosis in Hiv Infected Patients Admitted to the Bowring and Victoria Hospital During the Period September 2007 to September 2009

Hareesh¹,

R²,

Rekha³

et al. 2015

jemds

View full text Add to dashboard Cite

BACKGROUND: TE was the frequent CNS opportunistic infection in AIDS in the pre-HAART era. It occurred in 10% of the patients or more depending on the geographic origin, in areas where HAART is not used widely and where AIDS patients are not on appropriate anti-parasitic prophylaxis. Cerebral toxoplasmosis in AIDS almost always occurs from recrudescence of previously acquired infection. It usually occurs in patients with CD4 counts less than 100/μL. Most recently the incidence of cerebral toxoplasmosis has further decreased in the HAART era. The clinical profile of Cerebral toxoplasmosis is as similar to other neuro infection, but differs radiologically and treatment response. OBJECTIVES: The present study is taken up with respect to its clinical manifestations, diagnostic features, response to therapy and outcome. METHODS: We carried out a prospective observational study in 30 patients of cerebral toxoplasmosis who were HIV Seropositive, at Bowring & Victoria Hospitals attached to Bangalore Medical College and Research Institute, Bangalore from September 2007 to September 2009. RESULTS: Out of 30 patients studied, the mean age was35.7±9.3 years. Prevalence of TE was more in males (Ratio was 2.01). Headache and altered sensorium were more common presentation 73.3% each. Mean CD4 count was 59.57±5.32 (4:14 cells/μL). 22(73.3%) were positive for serum antitoxoplasma IgG antibodies. Majority of the TE patients 76.7% showed bilateral multiple ring enhancing hypodense lesion, 20% of the patients showed solitary lesions. Among the 30 patients, clinical outcome was good with 18(60%) improved to combination therapy of pyrimethamine plus sulfadiazine for a period of 14±2 days with minimum toxicity and 6 (20%)patients died during the therapy and 6(20%) patients lost follow up. CONCLUSION: TE was the AIDS defining illness in 50% of our patients. In patients with AIDS, TE is usually a presumptive diagnosis. CT scan brain, was found to be the most useful approach to the diagnosis. There was a significant relationship between CD4 counts of less than 100 cells/μL and development of TE in HIV seropositive patients. Seronegativitiy for anti-toxoplasma antibodies, does not rule out TE. Combination of oral pyrimethamine plus sulfadiazine therapy for a period of 14±2 days was effective in TE.

show abstract

“…In patients infected with human immunodeficiency virus (HIV), more than 95% of Toxoplasma encephalitis cases involve reactivation of a latent infection [2]. Contrary to the situation in adults, toxoplasmosis of the central nervous system is not a common opportunistic infection in children infected with HIV.…”

mentioning

confidence: 99%

Vertical transmission of HIV and toxoplasma by reactivation in a chronically infected woman

Fernandes

Vasconcellos

Araújo³

et al. 2009

Braz J Infect Dis

View full text Add to dashboard Cite

Prevention of mother-to-child transmission of HIV and Toxoplasma dual infections in the immunocompromised patient remains a healthcare challenge. We report a case of congenital toxoplasmosis resulting from reactivation of latent infection in a severely immunodepressed HIV-infected pregnant woman, who had poor adherence to therapy; this case illustrates the difficulties encountered in management of such a rare condition.

show abstract

Central nervous system toxoplasmosis in HIV pathogenesis, diagnosis, and therapy

Cited by 48 publications

References 34 publications

Diagnosis of Cerebral Toxoplasmosis in AIDS Patients in Brazil: Importance of Molecular and Immunological Methods Using Peripheral Blood Samples

Diagnosis of Cerebral Toxoplasmosis in AIDS Patients in Brazil: Importance of Molecular and Immunological Methods Using Peripheral Blood Samples

Clinical Profile of Cerebral Toxoplasmosis in Hiv Infected Patients Admitted to the Bowring and Victoria Hospital During the Period September 2007 to September 2009

Vertical transmission of HIV and toxoplasma by reactivation in a chronically infected woman

Contact Info

Product

Resources

About