Influence of neurotoxoplasmosis characteristics on real-time PCR sensitivity among AIDS patients in Brazil

Correia, Carolina da Cunha; Melo, Heloísa Ramos Lacerda de; Costa, Vlaudia Maria Assis

doi:10.1016/j.trstmh.2009.06.012

Cited by 36 publications

(35 citation statements)

References 28 publications

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“…These high sensitivities could indeed be in agreement with the higher virulence of parasite genotypes circulating in South America, but technical pitfalls could also explain such high rates. Indeed, a more recent study did not confirm these data, since those authors found only 29/82 (35%) and 1/85 positive CSF and blood samples, respectively (63).…”

Section: Diagnosis Of Toxoplasmosis In Immunocompromised Patientsmentioning

confidence: 88%

Epidemiology of and Diagnostic Strategies for Toxoplasmosis

2012

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SUMMARY The apicomplexan parasite Toxoplasma gondii was discovered a little over 100 years ago, but knowledge of its biological life cycle and its medical importance has grown in the last 40 years. This obligate intracellular parasite was identified early as a pathogen responsible for congenital infection, but its clinical expression and the importance of reactivations of infections in immunocompromised patients were recognized later, in the era of organ transplantation and HIV infection. Recent knowledge of host cell-parasite interactions and of parasite virulence has brought new insights into the comprehension of the pathophysiology of infection. In this review, we focus on epidemiological and diagnostic aspects, putting them in perspective with current knowledge of parasite genotypes. In particular, we provide critical information on diagnostic methods according to the patient's background and discuss the implementation of screening tools for congenital toxoplasmosis according to health policies.

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Section: Diagnosis Of Toxoplasmosis In Immunocompromised Patientsmentioning

confidence: 88%

Epidemiology of and Diagnostic Strategies for Toxoplasmosis

2012

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“…Molecular methods are particularly appropriate for AIDS patients since these methods are not affected by immunological status and are rapid, sensitive and specific (Colombo, Vidal et al 2005; Pereira-Chioccola, Vidal et al 2009). PCR using CSF has been reported to have a high specificity of 96 to 100% (Pereira-Chioccola, Vidal et al 2009; Correia, Melo et al 2010). However collection of CSF is invasion and may be inappropriate for patients with extensive cerebral lesions with extensive edema.…”

Section: Toxoplasmosis: Clinical Aspectsmentioning

confidence: 99%

“…However collection of CSF is invasion and may be inappropriate for patients with extensive cerebral lesions with extensive edema. Reports on the utility of PCR using peripheral blood samples for diagnosing cerebral toxoplasmosis have been variable (Correia, Melo et al 2010). …”

Section: Toxoplasmosis: Clinical Aspectsmentioning

confidence: 99%

Toxoplasmosis

Halonen,

Weiss

2013

Handbook of Clinical Neurology

317

272

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Toxoplasma gondii, an Apicomplexan, is a pathogen that can infect the central nervous system. Infection during pregnancy can result in a congenial infection with severe neurological sequela. In immune compromised individuals reactivation of latent neurological foci can result in encephalitis. Immune competent individuals infected with T. gondii are typically asymptomatic and maintain this infection for life. However, recent studies suggest that these asymptomatic infections may have effects on behavior and other physiological processes. T. gondii infects approximately one-third of the world population, making it one of the most successful parasitic organisms. Cats and other felidae serve as the definite host producing oocysts, an environmentally resistant life cycle stage found in cat feces, which can transmit the infection when ingested orally. A wide variety of warm-blooded animals, including humans, can serve as the intermediate host in which tissue cysts (containing bradyzoites) develop. Transmission also occurs due to ingestion of the tissue cysts. There are 3 predominant clonal lineages, termed types I, II and III and an association with higher pathogenicity with the Type I strains in humans has emerged. This chapter presents a review of the biology of this infection including the life cycle, transmission, epidemiology, parasite strains, and the host immune response. The major clinical outcomes of congenital infection, chorioretinitis, and encephalitis, and the possible association of infection of toxoplasmosis with neuropsychriatric disorders such as schizophrenia, are reviewed.

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“…For example, IgG titers in AIDS patients are often low and frequently below the sensitivity of detection. Diagnosis based on other biomarkers or PCR based molecular diagnostic techniques are being sought for these patients (26,27).…”

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confidence: 99%

Identification of Potential Serodiagnostic and Subunit Vaccine Antigens by Antibody Profiling of Toxoplasmosis Cases in Turkey

Liang

Döşkaya

Juárez

et al. 2011

Molecular & Cellular Proteomics

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Toxoplasmosis, caused by infection of the protozoan parasite Toxoplasma gondii, is associated with mild disease in healthy individuals, whereas individuals with depressed immunity may develop encephalitis, neurologic disorders, and other organ diseases. Women who develop acute toxoplasmosis during pregnancy are at risk of transmitting the infection to the fetus, which may lead to fetal damage. A diagnosis is usually confirmed by measuring IgG, or IgM where it is important to determine the onset of infection. A negative IgM result essentially excludes acute infection, whereas a positive IgM test is largely uninterpretable because IgM can persist for up to 18 months after infection. To identify antigens for improved diagnosis of acute infection, we probed protein microarrays displaying the polypeptide products of 1357 Toxoplasma exons with well-characterized sera from Turkey. The sera were classified according to conventional assays into (1) seronegative individuals with no history of T. gondii infection; (2) acute infections defined by clinical symptoms, high IgM titers, and low avidity IgG; (3) chronic/convalescent cases with high avidity IgG but persisting IgM; (iv) true chronic infections, defined by high avidity IgG and no IgM. We have identified 38 IgG target antigens and 108 IgM target antigens that can discriminate infected patients from healthy controls, one or more of which could form the basis of a 'tier-1 test to determine current or previous exposure. Of these, three IgG antigens and five IgM antigens have the potential to discriminate chronic/ IgM persisting or true chronics from recent acutely infected patients (a 'tier-2 test). Our analysis of the antigens revealed several enriched features relative to the whole proteome, which include transmembrane domains, signal peptides, or predicted localization at the outer membrane. This is the first protein microarray survey of the antibody response to T. gondii, and will

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Influence of neurotoxoplasmosis characteristics on real-time PCR sensitivity among AIDS patients in Brazil

Cited by 36 publications

References 28 publications

Epidemiology of and Diagnostic Strategies for Toxoplasmosis

Epidemiology of and Diagnostic Strategies for Toxoplasmosis

Toxoplasmosis

Identification of Potential Serodiagnostic and Subunit Vaccine Antigens by Antibody Profiling of Toxoplasmosis Cases in Turkey

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