Toxoplasma encephalitis in HIV/AIDS patients admitted to the Douala general hospital between 2004 and 2009: a cross sectional study

Luma, Henry Namme; Tchaleu, Benjamin Clet Nguenkam; Mapoure, Yacouba Njankouo; Temfack, Elvis; Doualla, Marie Solange; Halle, Marie Patrice; Joko, H Achu; Koulla‐Shiro, Sinata

doi:10.1186/1756-0500-6-146

Cited by 35 publications

(31 citation statements)

References 18 publications

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“…4 In a study involving 97 HIV patients with toxoplasma encephalitis, the median CD4 count was 68 cells/µl. 5 Similar findings have been observed in studies from Puerto Rico and Brazil where toxoplasma encephalitis was observed in patients with low CD4 count. 6,7 The incidence of toxoplasmosis varies by country and depends on the prevalence of T. gondii infection in the general population.…”

Section: Discussionsupporting

confidence: 76%

Cerebral Toxoplasmosis in a Treatment Naive HIV Patient with High CD4 Count Responding to Treatment with a Regime of Cotrimoxazole and Pyrimethamine: Do We Need to Start Prophylaxis for Toxoplasmosis at a Higher CD4 Count?

Swami¹,

Thakuria²,

Kharat³

2015

HIV/AIDS Res Treat Open J

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Section: Discussionsupporting

confidence: 76%

Cerebral Toxoplasmosis in a Treatment Naive HIV Patient with High CD4 Count Responding to Treatment with a Regime of Cotrimoxazole and Pyrimethamine: Do We Need to Start Prophylaxis for Toxoplasmosis at a Higher CD4 Count?

Swami¹,

Thakuria²,

Kharat³

2015

HIV/AIDS Res Treat Open J

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“…Penelitian oleh Goita et al (2012) juga ditemukan hal yang sama yaitu kejang merupakan gejala yang umum ditemukan pada toksoplasmosis cerebri. 14,15 Dari hasil CT scan didapatkan gambaran lesi hipodens multiple dengan kesan suatu abses serebri. Pada pasien HIV, gambaran toksoplasmosis serebri sering muncul dalam bentuk abses serebri.…”

Section: Laporan Kasusunclassified

Toxoplasmosis Cerebri Pada HIV AIDS

Derosa

Ahmad²

2018

JKA

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AbstrakToxoplasmosis cerebri merupakan salah satu infeksi oportunistik yang paling sering pada sistem saraf pusat pasien HIV. Infeksi toxoplasma Gondii pada pasien HIV terutama terjadi jika pada kondisi CD4 yang rendah, penurunan produksi sitokin dan interferon gama, dan menurunnya fungsi sel limfosit T sitotoksik sehingga menyebabkan reaktivasi dari infeksi laten T. Gondii. Telah dilaporkan laki-laki 31 tahun menderita HIV AIDS dengan toxoplasmosis cerebri. Pasien dirawat dengan penurunan kesadaran dan hemiparese sinistra, riwayat sakit kepala hebat dan sering berulang, memiliki riwayat menggunakan narkotik suntik dan pemakaian jarum suntik bergantian, tidak ada riwayat hipertensi, tidak ada riwayat tuberkulosis. Dari pemeriksaan fisik didapatkan kesadran apati, pupil isokor, pada mulut terdapat candidiasis oral, tidak ada kaku kuduk, terdapat lateralisasi tungkai ke kiri serta Babinski yang positif pada tungkai kiri. Pada pemeriksaan penunjang didapatkan Rapid test HIV yang positif, CD4 35sel/ul, dan gambaran CT scan otak yang sesuai Toxoplasmosis cerebri. Pasien ditatalaksana dengan pemberian Pirimetamin dan klindamisin selama 6 minggu ditambah steroid sampai pasien sadar. Abstract Cerebral Toxoplasmosis is one of commonest opportunistic infection of thr nervous system in HIV patient. In HIV infected patient opportunistic infection by T. Gondii occurs due to depletion of CD4 cells, decreased production of cytokine and interferon gamma and impaired cytotoxic T-Lymphocyte activity resulting in reactivation of latent infection. Reported a case, male 31 years old HIV AIDS with cerebral toxoplasmosis. Patient admitted to hospital with decreased of consciousness and left hemiparese, history of injecting drug used (IDU), no hypertension, no history of tuberculosis.In physical examination level of consciousness is apathy, pupil was isochor. there is oral candidiasis, absebce of stiffness of the neck, lateralitation to left lower extremity, and babinsky sign positif in left lower extremity. In laboratory found Rapid tes HIV testing was positif, CD4 cell count was 35cell/ul, Ig G anti toxoplasma positif dan brain ct scan suitable for cerebral toxoplasmosis. We treated patient with pyrimethamin, clindamycin for 6 weeks and steroid until conscious level was compos mentis cooperative.

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“…In Cameroon, some evidence have been reported on HIV/toxoplasmosis co-infection [14][15][16][17]. Of note, these previous reports showed emphasis on mortaility trensds [14], IgG and IgM testing [15], toxoplasmosis in hospitalised patients [16], and neurological disturbances associated with HIV/AIDS [17]. However, data on anti-toxoplasma gondii quantification, as well as its possible correlation with standard biomarkers of HIV infection (viral load and CD4), have not yet been ascertained.…”

Section: Introductionmentioning

confidence: 99%

High viremia and Poor Immunity are Potential Surrogates of Anti-toxoplasmic Immunoglobulin G Quantification among HIV-Infected Individuals: A Cross-sectional Study in Yaoundé, Cameroon

Ka’e¹,

Sosso²,

Fokam³

et al. 2020

Preprint

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Background: Toxoplasmosis remains a neglected common opportunistic infection in immunocompromised individuals, who are mainly people living with HIV (PLWHIV) in whom reactivation of toxoplasmosis may occur with advanced HIV conditions in resource-limited settings (RLS). Our objective was to evaluate the correlation between the anti-toxoplasmic IgG (Tg-IgG) concentration and the immuno-virological status of PLWHIV.Methods : A prospective and cross-sectional study was conducted among PLWHIV aged>18 years from February to November 2018 at the Chantal BIYA international Reference Centre. Blood samples were collected from eligible consenting PLWHIV; Tg-IgG level was assessed by quantitative ELISA, CD4-T lymphocytes counts were measured by flow cytometry and HIV-1 plasma viral load (PVL) measurement by real-time-PCR. Data were analysed using Excel and Graph Pad softwares; with p<0.05 considered statistically significant.Results : A total of 100 PLWHIV were enrolled: 56% seropositive for IgG anti- Toxoplasma gondii, 33% seronegative and 11% indeterminate results. According to viremia, 100% (19/19) of those with PVL>1000 copies/mL were seropositive to Tg-IgG versus 52.85% (37/70) of those with PVL<1000 copies/mL (median [IQR] IgG concentration 152.78 [139.24-444.43] versus 34.44 [13.04-36.47] IU/mL, respectively); p<0.0001. According to CD4, 100% (11/11) of those with T-CD4<200 cells/µL were seropositive to Tg-IgG versus 57.69% (45/78) of those with T-CD4>200 cells/µL (median IgG [IQR] 432.92 [145.06-450.47] versus 35.01 [15.01-38.01] IU/mL, respectively); p<0.0001. Interestingly, there were moderate-positive and strong-negative correlations respectively with HIV-1 PVL (r = 0.54; p<0.0001) and T-CD4 (r = -0.70; p<0.0001) as compared to Tg-IgG concentration. After adjusting for age, gender, immune status and PVL in logistic regression, only poor immune status (T-CD4<200 cells/µL) was independently associated to Tg-IgG seropositivity (p=0.0004).Conclusion : In a typical RLS like Cameroon, about half of PLWHIV might be seropositive to Tg-IgG. Of relevance, decreasing immunity appears with risk of increasing IgG anti- T gondii concentration, which suggests a relapse of toxoplasmosis. Thus, in the context of immunodeficiency, routine quantification of Tg-IgG would alleviate the programmatic burden of this opportunistic infection in RLS with generalized HIV epidemics.

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Toxoplasma encephalitis in HIV/AIDS patients admitted to the Douala general hospital between 2004 and 2009: a cross sectional study

Cited by 35 publications

References 18 publications

Cerebral Toxoplasmosis in a Treatment Naive HIV Patient with High CD4 Count Responding to Treatment with a Regime of Cotrimoxazole and Pyrimethamine: Do We Need to Start Prophylaxis for Toxoplasmosis at a Higher CD4 Count?

Cerebral Toxoplasmosis in a Treatment Naive HIV Patient with High CD4 Count Responding to Treatment with a Regime of Cotrimoxazole and Pyrimethamine: Do We Need to Start Prophylaxis for Toxoplasmosis at a Higher CD4 Count?

Toxoplasmosis Cerebri Pada HIV AIDS

High viremia and Poor Immunity are Potential Surrogates of Anti-toxoplasmic Immunoglobulin G Quantification among HIV-Infected Individuals: A Cross-sectional Study in Yaoundé, Cameroon

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