1921
Volume 84, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Highly active antiretroviral therapy (HAART) significantly reduced the toxoplasmic encephalitis (TE) incidence in acquired immunodeficiency syndrome (AIDS) patients. The TE incidence and mortality were evaluated in an AIDS cohort followed in Puerto Rico before, during, and after HAART implementation in the Island. Of the 2,431 AIDS studied patients 10.9% had TE diagnosis, with an incidence density that decreased from 5.9/100 person-years to 1.1/100 person-years after HAART. Cox proportional hazard analysis showed substantial mortality reduction among TE cases who received HAART. No mortality reduction was seen in those cases who received TE prophylaxis. Although this study shows a TE incidence and mortality reduction in the AIDS cohort after HAART, the incidence was higher than those reported in the United States AIDS patients. Poor TE prophylaxis compliance might explain the lack of impact of this intervention. Strengthening the diagnostic and opportune TE diagnosis and prompt initiation of HAART in susceptible patients is important to control this opportunistic infection.

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2011-05-05
2017-09-21
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References

  1. Abgrall S, Rabaud C, Costagliola D, , 2001. Incidence and risk factors for toxoplasmic encephalitis in HIV-infected patients before and during the HAART era. Clin Infect Dis 33: 17471755.[Crossref]
  2. Montoya JG, Remington JS, Mandell GL, Bennett JE, Odolin R, , 2000. Toxoplasma gondii . , eds. Principles and Practice of Infectious Diseases. Philadelphia, PA: Churchill Livingstone, 28582888.
  3. Luft BJ, Rennington JS, , 1992. Toxoplasmic encephalitis in AIDS. Clin Infect Dis 15: 211222.[Crossref]
  4. Pozio E, , 2004. Highly Active Antiretroviral Therapy and opportunistic protozoan infections. Parassitolog 46: 8993.
  5. Antinorio A, Larussa D, Cingolani A, Lorenzini P, Bossolasco S, Finazzi MG, Bongiovanni M, Guaraldi G, Grisetti S, Vigo B, Gigli B, Mariano A, Dalle Nogare E, De Marco M, Moretti F, Corsi P, Abrescia N, Rellecati P, Castagna A, Mussini C, Ammassari A, Cinque P, d'Arminio Monfort A, , 2004. Prevalence, associated factors, and prognostic determinants of AIDS-related toxoplasmic encephalitis in the era of advanced highly active antiretroviral therapy. Clin Infect Dis 39: 16811691.[Crossref]
  6. Jones JL, Hanson DL, Dworkin MS, Alderton DL, Fleming PL, Kaplan JE, Ward J, , 1999. Surveillance for AIDS-defining opportunistic illnesses, 1992–1997. MMWR CDC Surveill Summ 48: 122.
  7. CDC, 2006. HIV/AIDS Surveillance Report. Cases of HIV Infection and AIDS in the United States and Dependent Areas.
  8. Báez-Feliciano DV, Thomas JC, Gómez MA, Miranda S, Fernández DM, Velázquez M, Ríos-Olivares E, Hunter-Mellado RF, , 2005. Changes in the AIDS epidemiologic situation in Puerto Rico following health care reform and the introduction of HAART. Rev Panam Salud Publica 17: 92101.[Crossref]
  9. Hoffmann C, Ernst M, Meyer P, Wolf E, Rosenkranz T, Plettenberg A, Stoehr A, Horst HA, Marienfeld K, Lange C, , 2007. Evolving characteristics of toxoplamosis in patients infected with human immunodeficiency virus-1: clinical course and Toxoplasma gondii-specifi immune response. Clin Microbiol Infect 13: 510515.[Crossref]
  10. Cohen O, Weissman D, Fauci AS, Paul WE, , 1999. The immunopathogenesis of HIV infection. , ed. Fundamental Immunology. Philadelphia, PA: Lippincott-Raven, 14551509.
  11. Contini C, , 2008. Clinical and diagnostic management of toxoplasmosis in the immunocompromised patients. Parassitol 50: 4550.
  12. Subauste CS, Remington JS, , 1999. Immunity to Toxoplasma gondii . Curr Opin Immunol 4: 532537.
  13. Kaplan JE, Benson C, Holmes KK, Brooks JT, Pau A, Masur H, , 2009. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Recomm Rep 58: 1318.
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  • Received : 22 Dec 2010
  • Accepted : 04 Feb 2011

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