Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era

Martín-Iguacel, Raquel; Ahlström, Magnus Glindvad; Touma, Madeleine; Engsig, Frederik Neess; Stærke, Nina Breinholt; Stærkind, Mette; Obel, Niels; Rasmussen, Line Dahlerup

doi:10.1016/j.jinf.2017.05.018

Cited by 25 publications

(35 citation statements)

References 28 publications

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“…Prior to ART, overall survival was poor despite optimal antimicrobial therapy (40). In the ART era, both mortality and relapse of TE have decreased (57,76,(79)(80)(81)(82). Surprisingly, a recent systemic review showed a higher relapse rate for TE in patients on TMP-SMX maintenance therapy in the ART era than in the pre-ART era (19.2% versus 14.9%) (83).…”

Section: Immunocompromised Patientsmentioning

confidence: 99%

Treatment of Toxoplasmosis: Historical Perspective, Animal Models, and Current Clinical Practice

et al. 2018

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SUMMARYPrimary infection is usually subclinical, but cervical lymphadenopathy or ocular disease can be present in some patients. Active infection is characterized by tachyzoites, while tissue cysts characterize latent disease. Infection in the fetus and in immunocompromised patients can cause devastating disease. The combination of pyrimethamine and sulfadiazine (pyr-sulf), targeting the active stage of the infection, is the current gold standard for treating toxoplasmosis, but failure rates remain significant. Although other regimens are available, including pyrimethamine in combination with clindamycin, atovaquone, clarithromycin, or azithromycin or monotherapy with trimethoprim-sulfamethoxazole (TMP-SMX) or atovaquone, none have been found to be superior to pyr-sulf, and no regimen is active against the latent stage of the infection. Furthermore, the efficacy of these regimens against ocular disease remains uncertain. In multiple studies, systematic screening for infection during gestation, followed by treatment with spiramycin for acute maternal infections and with pyr-sulf for those with established fetal infection, has been shown to be effective at preventing vertical transmission and minimizing the severity of congenital toxoplasmosis (CT). Despite significant progress in treating human disease, there is a strong impetus to develop novel therapeutics for both the acute and latent forms of the infection. Here we present an overview of toxoplasmosis treatment in humans and in animal models. Additional research is needed to identify novel drugs by use of innovative high-throughput screening technologies and to improve experimental models to reflect human disease. Such advances will pave the way for lead candidates to be tested in thoroughly designed clinical trials in defined patient populations.

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Section: Immunocompromised Patientsmentioning

confidence: 99%

Treatment of Toxoplasmosis: Historical Perspective, Animal Models, and Current Clinical Practice

et al. 2018

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“…As a result, individuals diagnosed with HIV or neurotoxoplasmosis during the ART era could be considered as with low risk of mortality. Therefore, early HIV diagnosis and ART initiation are of paramount importance 26 .…”

Section: Discussionmentioning

confidence: 99%

Quality of life and handgrip strength of HIV patients diagnosed with neurotoxoplasmosis

Gouvêa-e-Silva

Lima

Fernandes

et al. 2019

Rev. bras. cineantropom. desempenho hum.

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HIV / AIDS epidemic continues to be a major public health problem, and when there is poor adherence to treatment, patients become susceptible to other infections such as toxoplasmosis. The aim of this study was to evaluate the handgrip strength and quality of life of HIV infected patients diagnosed with neurotoxoplasmosis. A cross-sectional study was conducted with 40 HIV-infected patients, with and without diagnosis of neuroxoplasmosis.Sociodemographic and clinical profile information was collected, and handgrip strength and quality of life were evaluated. Almost all patients of both groups used antiretroviral therapy. In the handgrip strength evaluation, no statistical difference was observed for the right and left hand between groups with and without neurotoxoplasmosis (p> 0.05). However, the classifica-1 Federal University of Pará. Gradution of inadequate handgrip strength in the neurotoxoplasmosis group was significantly higher.ate Program in Tropical Diseases. In the quality of life domain, it was observed that financial concern had lower scores in the Belém, PA. Brazil. group with neurotoxoplasmosis (p = 0.0379). It was observed that neurotoxoplasmosis showedno association with epidemiological, clinical, handgrip strength and quality of life variables.2 State University of Pará. Center However, patients with neurotoxoplasmosis showed a trend towards lower muscle strength.

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“…In another meta-analysis, patients with HIV/AIDS compared to HIV-negative population had higher seroprevalence of T. gondii; the rates were 46.12% vs 36.56%, respectively (4). Although the rate declined after highly active antiretroviral treatment era, cerebral toxoplasmosis is still considered to be one of the most common of the opportunistic central nervous system infections of patients with HIV infection (5). Cerebral toxoplasmosis occurs most commonly in HIVinfected patients having CD4 counts below 100 cells/mm 3 ; however, rare cases are reported among patients having CD4 counts up to 200 cells/mm 3 (6).…”

Section: Introductionmentioning

confidence: 99%

Difference in <i>Toxoplasma gondii</i> Seroprevalence Rates Due to Low and High CD4 Counts in Patients with HIV/AIDS

Yeni̇lmez

Çeti̇nkaya

2019

Turkiye Parazitol Derg

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Amaç: İnsan bağışıklık yetmezliği virüsü (HIV)/Edinilmiş bağışıklık yetmezliği sendromu (AIDS) hastalarında semptomatik toxoplazmoz, hemen hemen her zaman kronik enfeksiyonun yeniden aktivasyonu sonucu meydana gelmektedir. Bu hastalarda Toxoplazma serolojisinin taranmasının ana hastalığın takibindeki önemi büyüktür. Bu meta-analizde, HIV-pozitif popülasyondaki Toxoplasma gondii seroprevalans oranlarının düşük (CD4 <200 hücre/mm 3) ve yüksek (CD4 ≥200 hücre/mm 3) CD4 sayılarına sahip hastalarda farklılık gösterip göstermediğini araştırmayı amaçladık.

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Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era

Cited by 25 publications

References 28 publications

Treatment of Toxoplasmosis: Historical Perspective, Animal Models, and Current Clinical Practice

Treatment of Toxoplasmosis: Historical Perspective, Animal Models, and Current Clinical Practice

Quality of life and handgrip strength of HIV patients diagnosed with neurotoxoplasmosis

Difference in <i>Toxoplasma gondii</i> Seroprevalence Rates Due to Low and High CD4 Counts in Patients with HIV/AIDS

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