Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis

Abstract

We conducted a retrospective analysis of Toxoplasma encephalitis patients from Instituto de Infectologia Emílio Ribas, the main AIDS hospital of São Paulo, Brazil, during two different stages of the HIV epidemics, in 1988 (38 patients) and 1991 (33 patients). There were AIDS-related demographic differences, but the clinical presentation and diagnostic efficiency were similar, usually based on tomography and clinical response to therapy, with a clear distinction from other CNS infections, based on clinical and laboratory findings. Specific serologic studies were performed less often in 1991, with a high frequency of therapy change. The direct acute death rate from Toxoplasma encephalitis was high during both periods, i.e. 8/38 in 1988 and 10/33 in 1991. The direct acute death rate for the patients from the two periods as a whole was 25.4% (18/71), related to the time of HIV infection, absence of fever and presence of meningeal irritation at presentation, blood leukocytes higher than 10,000/mm3 and blood lymphocytes lower than 350/mm3. Toxoplasma encephalitis is a preventable disease when adequate prophylactic therapy is used and is relatively easy to treat in diagnosed HIV patients. Unfortunately, this severe and deadly disorder is the HIV diagnostic disease in several patients, and our data support the need for careful management of these patients, especially in those countries with a high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems.

Preliminary report of HIV and Toxoplasma gondii occurrence in pregnant women from Mozambique

“…Toxoplasmosis can cause severe disease in fetuses of acutely infected pregnant women (MONTOYA & REMINGTON, 2008). Additionally, the reactivation of latent infection occurs in immune compromised patients, causing life-threatening disease, especially encephalitis (PASSOS et al, 2000). Encephalitis due to reactivated toxoplasmosis is one of the most common opportunistic neurological infections in AIDS patients, typically observed in the later stages of human immunodeficiency virus (HIV) infection (MASCHKE et al, 2000).…”

“…Encephalitis due to reactivated toxoplasmosis is one of the most common opportunistic neurological infections in AIDS patients, typically observed in the later stages of human immunodeficiency virus (HIV) infection (MASCHKE et al, 2000). Its incidence is directly related to the prevalence of anti-T. gondii antibodies in the general population (PASSOS et al, 2000). The prevalence of toxoplasmosis (between 30% and 60% in most countries) varies widely in different regions of the globe (TENTER et al, 2000).…”

Prevalence of IgG antibodies specific to Toxoplasma gondii among blood donors in Recife, Northeast Brazil

“…Usually, people suffering from both AIDS and toxoplasmosis have been exposed to the Toxoplasma parasite earlier in life and the HIV infection simply allowed the Toxoplasma parasite to grow unchecked. The concomitant occurrences should be considered by public health policies especially in those countries with high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems 15 .…”

Toxoplasma gondii vs radiação ionizante: imunidade humoral e celular em baço e intestino de camundongos isogênicos imunizados com taquizoítos irradiados por Cobalto 60

“…Em São Paulo, um levantamento realizado em 1988 e 1991 apresentou respectivamente 21% e 46% de encefalite por toxoplasma em pacientes com AIDS (PASSOS et al, 2000), sendo que a toxoplasmose é uma das principais causas associadas em mortes por AIDS, responsável por 12,2% dos óbitos (SANTOS et al, 2000).…”

“…( PASSOS et al, 2000), sendo que a toxoplasmose é uma das principais causas associadas em mortes por AIDS, responsável por 12,2% dos óbitos (SANTOS et al, 2000).…”