TOXOPLASMOSIS IN PATIENTS WITH ACQUIRED IMMUNODEFICIENCY SYNDROME

Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.

TOXOPLASMOSIS IN PATIENTS WITH ACQUIRED IMMUNODEFICIENCY SYNDROME

Infect Dis Ther; 3:341-54 1989. Unique Identifier : AIDSLINE ICDB/90665453
Kovacs JA; Critical Care Medicine Dept., NIH, Bethesda, MD

Abstract: Toxoplasma gondii is a major pathogen of patients (pts) with AIDS. In this pt population, T gondii can cause severe morbidity and mortality, usually from focal encephalitis, but occasionally from more widely disseminated disease. T-gondii infection in AIDS is reviewed, including life cycle of T gondii, epidemiology and clinical manifestations in immunocompetent hosts and in pts with AIDS, histopathology, laboratory evaluation, diagnosis, differential diagnosis, and therapy. Toxoplasmosis in pts with AIDS is similar to other opportunistic infections seen in this pt population. The diagnosis may be difficult to establish because standard serologic assays are not useful, and therapy, although effective, needs to be continued for prolonged periods because of the high frequency of relapse following discontinuation. Available therapy is limited and associated with a high prevalence of adverse reactions. The ultimate prognosis of pts with toxoplasmosis, even those who respond to therapy, is poor. The median survival of 56/61 pts who died in one study was 4 mo (range: 7 days to 18 mo). Improved methods of diagnosis and improved therapeutic regimens clearly are needed for toxoplasmosis in AIDS. However, without reversal of the immunosuppression associated with AIDS, the prognosis of toxoplasmosis almost certainly will remain grim in this population. (35 Refs)

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/DIAGNOSIS Diagnosis, Differential Drug Therapy, Combination Human Opportunistic Infections/*COMPLICATIONS/DIAGNOSIS/DRUG THERAPY Pyrimethamine/THERAPEUTIC USE Sulfonamides/THERAPEUTIC USE Toxoplasmosis/*COMPLICATIONS/DIAGNOSIS/DRUG THERAPY JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
901030
M90A0683

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