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Serology for toxoplasmosis in HIV positive patients.
Grinbaum R; Levi G; De Mendonca JS; Hospital Servidor Publico Estadual,
December 30, 1995
Natl Conf Hum Retroviruses Relat Infect (1st). 1993 Dec 12-16;:139.

Cerebral Toxoplasmosis (CT) is a severe opportunistic infection occurring in 15-48% of AIDS patients. Disease results more frequently from reactivation than from primary infection. Detection of IgG by methods such as indirect immunofluorescence (IF) is compatible with active or previous infection with T. gondii. The importance of the previous titres of IF as a prognostic factor to the development of CT still needs better evaluation. We carried out a retrospective study to evaluate the significance of high titres of IF in HIV patients. We included patients in whom IF was performed at least one month before diagnosis of CT or loss of follow up, defined as death or end of study period. CT was defined as disease with signs and symptoms of focal neurologic disease with one or more of the following criteria: (a) suggestive neuroradiologic lesions and response to therapy or (b) active T. gondii infection demonstrated on anatomopathological examination. Patients were subdivided in three groups: (1) IF titres less than or equal to 1:64; (2) IF titres superior to 1:64 but inferior to 1:1024, and (3) IF titres greater than or equal to 1:1024. We compared groups for CD4 cells count, mean time of follow up and CT diagnosis after 3,6 and 9 months. 136 patients were included, 45 in group 1, 51 in group 2 and 40 in group 3. No differences were observed for age and mean time of follow up, but CD4 cells count were significantly higher in group 3 (p=0.01). In the table, proportion of patients in which CT was diagnosed: (table: see text). We conclude that elevated titres of IF may suggest high risk of development of CT. Although primary prophylaxis has not been completely evaluated, we must consider this possibility. IF may be one of the markers of this approach.

CD4 Lymphocyte Count Human HIV Infections/*COMPLICATIONS Placebos Risk Factors Toxoplasmosis, Ocular/*COMPLICATIONS/EPIDEMIOLOGY ABSTRACT