Abstract
We studied 41 AIDS patients in the Austrian Tyrol with respect to toxoplasma antibody titers and the presence of CNS toxoplasmosis. In no patient had primary Pneumocystis carinii pneumonia (PcP) prophylaxis with either trimethoprim/sulfamethoxazole or pyrimethamine/sulfadoxine been applied; the degree to which CNS toxoplasmosis is influenced by this kind of PcP chemoprophylaxis, widely used elsewhere, is still unclear. In this study 47.4% of toxoplasmaseropositive patients developed CNS toxoplasmosis, compared to the previously estimated risk of 12%–28% for developing CNS involvement in such patients. In view of the high risk of toxoplasma-seropositive patients with AIDS, increased efforts in developing a well-tolerated chemoprophylaxis to combat CNS toxoplasmosis are required.
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References
Brooks RG, McCabe RE, Remington JS (1987) Role of serology in the diagnosis of toxoplasmic lymphadenopathy. Rev Infect Dis 9:775–782
Centers for Disease Control (1987) Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. MMWR 36 [Suppl]:1–15
Chaisson RE, Volberding PA (1990) Clinical manifestations of HIV infection. In: Mandell GL, Douglas RG, Bennett JE (eds) Principles and practice of infectious diseases, 3rd edn. Churchill Livingstone, New York Edinburgh London Melbourne, pp 1059–1092
Cohn JA, McMeeking A, Cohen W, Jacobs J, Holzman RS (1989) Evaluation of the policy of empiric treatment of suspected toxoplasma encephalitis in patients with the acquired immunodeficiency syndrome. Am J Med 86:512–527
Derouin F, Beauvais B, Lariviere M (1986) Serological study of the prevalence of toxoplasmosis in 167 patients with acquired immunodeficiency syndrome (AIDS) or chronic lymphadenopathy syndrome (LAS). Biomed Pharmacother 40:231–232
Fille M, Allerberger F, Dierich MP (1989) Untersuchungen über den Durchseuchungsgrad an Toxoplasmose in Tirol. Mitt Österr Sanitätsverwalt (Vienna) 90:1–3
Fleck DG, Kwantes W (1980) The laboratory diagnosis of toxoplasmosis. PHLS Monograph 13. Her Majesty's Stationery Office, London
Girard PM, Landman R, Gaudebout C, Lepretre A, Lottin P, Micon C, de Truchi P, Matheron S, Camus F, Farinotti R, Marche C, Couland JP, Saimot AG (1989) Prevention of Pneumocystis carinii pneumonia relapse by pentamidine aerosol in Zidovudine-treated AIDS patients. Lancet I:1348–1353
Grant IH, Gold JWM, Rosenblum M, Niedwiecki D, Armstrong D (1990) Toxoplasma gondii serology in HIV-infected patients: the development of central nervous system toxoplasmosis in AIDS. AIDS 4:519–521
Haverkos HW (1987) Assessment of therapy for toxoplasma encephalitis. The TE Study Group. Am J Med 82:907–914
Hofflin JM, Conley FK, Remington JS (1987) Murine model of intracerebral toxoplasmosis. J Infect Dis 155:550–557
Kovacs JA, Masur H (1989) AIDS commentary: prophylaxis of Pneumocystis carinii pneumonia: an update. J Infect Dis 160:882–886
Leport C, Raffi F, Matheron S, Katlama C, Regnier B, Saimot AG, Marche C, Vedrenne C, Vilde JL (1988) Treatment of central nervous system toxoplasmosis with pyrimethamine/ sulfadiazine combination in 35 patients with the acquired immunodeficiency syndrome. Am J Med 84:94–100
Levy RM, Bredesen DE, Rosenblum ML (1985) Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature. J Neurosurg 62:475–495
Luft BJ, Remington JS (1988) AIDS commentary. Toxoplasmic encephalitis. J Infect Dis 157:1–6
Luft BJ, Conley F, Remington JS, Laverdiere M, Wagner KF, Levine JF, Craven PC, Stranberg DA, File TM, Rice N, Meunier-Carpentier F (1983) Outbreak of central-nervous-system toxoplasmosis in Western Europe and North America. Lancet I:781–784
Luft BJ, Brooks RG, Conley FK, McCabe RE, Remington JS (1984) Toxoplasmic encephalitis in patients with acquired immune deficiency syndrome. JAMA 252:913–917
Matheron S, Dournon E, Garakhanian S, Leport C, Detruchis P, Gaudebout C (1990) Prevalence of toxoplasmosis in 356 AIDS and ARC patients before and during Zytovudine treatment. VI. Conference on AIDS, San Francisco, June 1990. Regents of the University of California, San Francisco, abstract Th.B476
Mills J (1986) Pneumocystis carinii and Toxoplasma gondii infections in patients with AIDS. Rev Infect Dis 8:1001–1011
Pedrol E, Gonzales-Clemente JM, Gatell JM, Mallolas J, Mirol JM, Craus F, Alvarez R, Mercader JM, Berenguer J, Jimenez de Anta MT, Valls ME, Soriano E (1990) Central nervous toxoplasmosis in AIDS patients: efficacy of an intermittent maintenance therapy. AIDS 4:511–517
Sabin AB, Warren J (1941) Therapeutic effect of the sulfonamides on infection by an intracellular protozoon (toxoplasma). J Bacteriol 41:80–86
Solbreux P, Sonnet J, Zech F (1990) A retrospective study about the use of cotrimoxazole as diagnostic support and treatment of suspected cerebral toxoplasmosis in AIDS. Acta Clin Belg 45:85–96
Suzuki Y, Israelski DM, Dannemann BR, Stepick-Bick P, Thulliez P, Remington JS (1988) Diagnosis of toxoplasmic encephalitis in patients with acquired immunodeficiency syndrome by using a new serologic method. J Clin Microbiol 26:2541–2543
Thomas S, O'Dohety M, Bateman N (1990) Pneumocystis carinii pneumonia: aerolised pentamidine gives effective prophylaxis. Br Med J 300:211–212
Wong B, Gold JW, Brown AE, Lange M, Fried R, Grieco M, Mildvan D, Giron J, Trapper ML, Lerner CW (1984) Central nervous system toxoplasmosis in homosexual men and parenteral drug abusers. Ann Intern Med 100:36–42
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Zangerle, R., Allerberger, F., Pohl, P. et al. High risk of developing toxoplasmic encephalitis in AIDS patients seropositive to Toxoplasma gondii . Med Microbiol Immunol 180, 59–66 (1991). https://doi.org/10.1007/BF00193846
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DOI: https://doi.org/10.1007/BF00193846