Restoration of Toxoplasma gondii-specific immune responses in patients with AIDS starting HAART

Furco, André; Carmagnat, Maryvonnick; Chevret, Sylvie; Garin, Y. J. F.; Pavie, Juliette; Castro, Nathalie De; Charron, Dominique; Derouin, Francis; Molina, Jean‐Michel

doi:10.1097/qad.0b013e3283136d68

Cited by 18 publications

(9 citation statements)

References 31 publications

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“…It is possible that they may have rapidly restored their cellular immunity, and subsequently mounted a strong immune response to Toxoplasma gondii [48]. The higher antibody titre in this case might reflect a more robust response to Toxoplasma gondii as reported previously [49], or a seroconversion closer to the time of NC testing [50] as opposed to a subclinical reactivation of Toxoplasma infection in the brain [51]. …”

Section: Discussionmentioning

confidence: 85%

Latent toxoplasmosis is associated with neurocognitive impairment in young adults with and without chronic HIV infection

Ene

Marcotte

Umlauf

et al. 2016

Journal of Neuroimmunology

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We evaluated the impact of latent toxoplasmosis (LT) on neurocognitive (NC) and neurobehavioural functioning in young adults with and without chronic HIV infection, using a standardised NC test battery, self-reported Beck Depression Inventory, Frontal System Behaviour Scale, MINI-International Neuropsychiatric Interview and risk-assessment battery. 194 young adults (median age 24 years, 48.2% males) with chronic HIV infection (HIV+) since childhood and 51 HIV seronegative (HIV-) participants were included. HIV+ individuals had good current immunological status (median CD4: 479 cells/μL) despite a low CD4 nadir (median: 93 cells/μL). LT (positive anti-Toxoplasma IgG antibodies) was present in one third of participants. The impairment rates in the HIV- with and without Toxo were not significantly different (p=0.17). However, we observed an increasing trend (p<0.001) in impairment rates with HIV and LT status: HIV-/LT- (6.1%); HIV-/LT+ (22%), HIV+/LT- (31%), HIV+/LT+ (49%). In a multivariable analysis using the entire study group there were main effects on cognition for HIV and also for LT. Within the HIV+ group LT was associated with worse performance globally (p=0.006), in memory (p=0.009), speed of information processing (p=0.01), verbal (p=0.02) and learning (p=0.02) domains. LT was not associated with depressive symptoms, frontal systems dysfunction or risk behaviors in any of the groups. HIV participants with lower Toxoplasma antibody concentration had worse NC performance, with higher GDS values (p=0.03) and worse learning (p=0.002), memory (p=0.006), speed of information processing (p=0.01) T scores. Latent Toxoplasmosis may contribute to NC impairment in young adults, including those with and without chronic HIV infection.

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Section: Discussionmentioning

confidence: 85%

Latent toxoplasmosis is associated with neurocognitive impairment in young adults with and without chronic HIV infection

Ene

Marcotte

Umlauf

et al. 2016

Journal of Neuroimmunology

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“…A low CD4 cell count has been identified as a significant risk factor in AIDS patients with CT (Tsambiras et al, 2001;de Boer et al, 2003;Sendi et al, 2006;Chen et al, 2009;Caby et al, 2010;Kung et al, 2011) due to impaired proliferative response to Toxoplasma antigen (Belanger et al, 1999), a decreased production of interferon  (Ullum et al, 1997), and it is found to be more common that IRIS develops in HIV-infected patients (Jevtović et al, 2005). Therefore, monitoring of CD4/CD8 T cells in patients on HAART might serve as a better marker for the restoration of T. gondii-specific immune responses than the total number of CD4 cells count (Furco et al, 2008). Immune reconstitution under HAART has been associated with a restoration of immune responses against T. gondii (Fournier et al, 2001).…”

Section: Immune Reconstitution Inflammatory Syndrome (Iris) -From Pasmentioning

confidence: 99%

Toxoplasmosis in HIV/AIDS Patients - A Living Legacy

Nissapatorn¹

2011

Microbes, Viruses and Parasites in AIDS Process

101

124

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“…A low CD4 + cell count has been identified as a significant risk factor in AIDS patients with CT93130–134 due to impaired proliferative response to Toxoplasma antigen135, a decreased production of interferon γ136, and IRIS develops more commonly in HIV-infected patients137. Therefore, monitoring of CD4 + /CD8 + T cells in patients on HAART might serve as a better marker for the restoration of T. gondii -specific immune responses than the total number of CD4 + cells count138. Immune reconstitution under HAART has been associated with a restoration of immune responses against T. gondii 139.…”

Section: Immune Reconstitution Inflammatory Syndrome (Iris) Associatementioning

confidence: 99%

Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges

Nissapatorn¹,

Sawangjaroen²

2011

Indian J Med Res

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After 30 years of the human immunodeficiency virus (HIV) epidemic, parasites have been one of the most common opportunistic infections (OIs) and one of the most frequent causes of morbidity and mortality associated with HIV-infected patients. Due to severe immunosuppression, enteric parasitic pathogens in general are emerging and are OIs capable of causing diarrhoeal disease associated with HIV. Of these, Cryptosporidium parvum and Isospora belli are the two most common intestinal protozoan parasites and pose a public health problem in acquired immunodeficiency syndrome (AIDS) patients. These are the only two enteric protozoan parasites that remain in the case definition of AIDS till today. Leismaniasis, strongyloidiasis and toxoplasmosis are the three main opportunistic causes of systemic involvements reported in HIV-infected patients. Of these, toxoplasmosis is the most important parasitic infection associated with the central nervous system. Due to its complexity in nature, toxoplasmosis is the only parasitic disease capable of not only causing focal but also disseminated forms and it has been included in AIDS-defining illnesses (ADI) ever since. With the introduction of highly active anti-retroviral therapy (HAART), cryptosporidiosis, leishmaniasis, schistosomiasis, strongyloidiasis, and toxoplasmosis are among parasitic diseases reported in association with immune reconstitution inflammatory syndrome (IRIS). This review addresses various aspects of parasitic infections in term of clinical, diagnostic and therapeutic challenges associated with HIV-infection.

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Restoration of Toxoplasma gondii-specific immune responses in patients with AIDS starting HAART

Cited by 18 publications

References 31 publications

Latent toxoplasmosis is associated with neurocognitive impairment in young adults with and without chronic HIV infection

Latent toxoplasmosis is associated with neurocognitive impairment in young adults with and without chronic HIV infection

Toxoplasmosis in HIV/AIDS Patients - A Living Legacy

Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges

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