AEGiS-15IAC: Toxoplasmosis in HIV/AIDS patients: a current situation.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Toxoplasmosis in HIV/AIDS patients: a current situation.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10247)

Nissapatorn V, Lee CK, Quek KF, Leong CL, Rohela M, Khairul Anuar A
Department of Parasitology, University of Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia

BACKGROUND: To determine the seroprevalence of toxoplasmosis among HIV/AIDS patients, and to determine the frequency distribution and the course of toxoplasmic encephalitis among AIDS patients.

METHODS: We retrospectively reviewed 505 HIV/AIDS patients who attended in the Hospital Kuala Lumpur from the period of January 2001 to March 2003.

RESULTS: The seroprevalence of toxoplasmosis among these patients was 226 (44.8%; 95% CI 42.64 -51.76). 57 (11.3%) out of 505 patients were diagnosed as AIDS-related toxoplasmic encephalitis (TE). Their age ranged from 17 to 48 years with a mean of 34.4 (SD±7.3) years, while, the predominant age group was 25-34 years. The majority of patients comprised of males 49 (86%), Chinese 28 (49%), singles 40 (70.2%), unemployed 43 (75.4%) and resided outside Kuala Lumpur 39 (68.4%). The heterosexual was accounted for 29 (51%) as the most frequent risk behavior to HIV infection. The most common clinical manifestation was headache (56%). The CT scan findings showed most lesions to be multiple (96.4%), hypodense (66.7%), and in parietal region (39.3%). 27 (47.4%) patients had chronic (latent) Toxoplasma infection as evidenced by seropositivity for anti-Toxoplasma (IgG) antibody. At the time of diagnosis, the range of CD4 cell count was from 0-239 with a median of 25 cells/cumm. The significant relation between patients with CD4 count of less than 100 cells/cumm when they developed toxoplasmic encephalitis was observed (p<0.05). Clinical outcomes showed that among those who survived, 21 (36.8%), 16 (28.1%), and 2 (3.5%) of patients had completed treatment, transferred out, and lost to follow up respectively, unfortunately, 18 (31.6%) of the cases were officially pronounced dead. Overall, 7 (12.3%) of them were detected as recurrent TE in this study.

CONCLUSION: The effectiveness of HAART therapy seems to be a promising agent in lowering the incidence of toxoplasmic encephalitis in this particular moment.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Toxoplasmosis, HIV Seropositivity, HIV Infections, CD4 Lymphocyte Count, Incidence, Encephalitis, Toxoplasma, Seroepidemiologic Studies, Antiretroviral Therapy, Highly Active, Humans, Male, Animal

040711
B10247