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Evidence for genetic regulation of susceptibility to toxoplasmic encephalitis in AIDS patients.
Suzuki Y; Wong SY; Grumet FC; Fessel J; Montoya JG; Zolopa AR; Portmore
November 30, 1996
3rd Conf Retro and Opportun Infect. 1996 Jan 28-Feb 1;:160. Unique

Toxoplasmic encephalitis (TE) in patients with AIDS is almost always caused by recrudescence of a previously latent T. gondii infection. Prior to the use of primary prophylaxis, approximately 30% of patients with AIDS who had antibodies to T. gondii developed TE , suggesting that susceptibility to TE may, at least in part, be under genetic control in those patients. In the present study. we examined the frequency of HLA-DQ antigens in AIDS patients with TE and found that the frequency of HLA-DQ3 was significantly elevated in North American Caucasian AIDS patients who developed TE (85.0%) compared to the general Caucasian population (51.8%; p=0.007, PC=0.028) or randomly selected control AIDS patients who had not developed TE (40.0%; p=0.016). In contrast. the frequency of HLA-DQ1 was lower in TE patients than in the healthy controls (40.0% vs 66.5%; p=0.027), but this difference did not reach statistical significance when corrected for the number of variables tested (pc=0.108). HLA-DQ3 thus appears to serve as a genetic marker of susceptibility to development of TE in AIDS patients. while DQ1 maybe a resistance marker. These HLA and disease associations indicate that development of TE in AIDS patients is affected by a gene or genes in the HLA complex, and that HLA-DQ typing may help in decisions regarding TE prophylaxis when the patients suffer severe side effects of the drugs.

Acquired Immunodeficiency Syndrome/*COMPLICATIONS Disease Susceptibility/GENETICS Encephalitis/COMPLICATIONS/*GENETICS HLA-DQ Antigens/*GENETICS Human Random Allocation Toxoplasmosis/COMPLICATIONS/*GENETICS ABSTRACT