Summary
There is much hope that HIV-infected patients and AIDS patients can reckon with a prolonged survival in future. The increased survival of AIDS patients with positiveToxoplasma serology is not necessarily associated with an increased risk of developingToxoplasma encephalitis. For HIV-infected patients with negativeToxoplasma serology, the probability of acquiring a primaryToxoplasma infection in highly endemic areas such as Germany had not been studied to date. One hundred eighty-three HIV-infected patients were followed up between 1987 and 1995 in a retrospective study. Within the cohort, 95% of the patients were male and 83% haemophiliacs. The initial (1987) and final (1995) prevalence rate ofToxoplasma antibodies was 33.3% and 36.6%, respectively. The annual rise of the primary infection rate was calculated as 0.41%. The dye test was used for the detection ofToxoplasma-specific antibodies. This assay proved to be reliable and stable during long-term observation. The rate of primary toxoplasmosis found in this long-term study was not higher than that of pregnant women in Germany. Chemoprophylactic measurements for seronegative HIV-infected patients are therefore not recommended, but regular serological screening to detect seroconverters is.
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Grant, H. L., Gold, W. M., Rosenblum, M., Niedzwiecki, D., Armstrong, D.:Toxoplasma gondii serology in HIV-infected patients: the development of central nervous system toxoplasmosis in AIDS. AIDS 4 (1990) 519–521.
Pohle, H. D.: Toxoplasmose bei Immunsuppression. In:Pohle, H. D., Remington, J. S. (eds.): Toxoplasmose-Erreger und Krankheit. Socio-medico Verlag, Gräfelfing 1994, pp. 141–164.
Montaner, J. S. G., Le Th., Hogg, R., Ricketts, M., Sutherland, D., Strathdee, St. A., O'Shaughnessy, M., Schlechter, M. T.: The changing spectrum of AIDS index diseases in Canada. AIDS 8 (5) (1994) 693–695.
RKI-Hefte, AIDS/HIV 1995: Berichte zur epidemiologischen Situation in der Bundesrepublik Deutschland zum 31.12.1995. RKI-Heft 13 (1996) 104–105.
Ockert, G.: Epidemiologie der Toxoplasmose. In:Shah, W., Stille, W. (eds.): Infektionen durchToxoplasma gondii. Socio-medico Verlag, Gräfelfing 1991, pp. 19–32.
Desmont, G.: Toxoplasmosis in France. Asian J. Clin. Sci. 7 (1987) 89–109.
Aspöck, H., Flamm, H., Picher, O.: Die Toxoplasmose-Überwachung während der Schwangerschaft. 10 Jahre Erfahrung in Österreich. Mitt. Österr. Ges. Tropenmed. Parasitol. 8 (1986) 105–113.
Kovacs, J. A.: Toxoplasmosis in patients with acquired immunodeficiency syndrome. In:Leoung, G., Mills, J. (eds.): Opportunistic infections in patients with the acquired immunodeficiency syndrome. Marcel Dekker, New York 1989, pp. 343–354.
Luft, B. J., Brooks, R. G., Conley, F. K., McCabe, R. E., Remington, J. S.:Toxoplasma encephalitis in patients with acquired immune deficiency syndrome. JAMA 252 (1984) 913–917.
Centers for Disease Control: 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 41 (RR-17) (1992) 1–19.
Kamps, B. S., Brodt, H. R., Staszewski, S., Bergmann, L., Helm, E. B.: AIDS-free survival and overall survival in HIV infection. The new CDC classification (1993) for HIV disease and AIDS. Clin Invest. 72 (1994) 287–292.
Sabin, A. B., Feldman, H. A.: Dyes as microchemical indicators of a new immunity phenomenon affecting a protozoan parasite (Toxoplasma). Science 108 (1948) 660–663.
Zur einheitlichen Laboratoriumsdiagnostik der Toxoplasmose. Empfehlungen für die Durchführung derToxoplasma-Seroreaktionen. I. Sabin-Feldmann-Test II. Komplementbindungsreaktion. Bundesgesundheitsblatt 23 (1966) 354–357.
Saathoff, M., Seitz, H. M.: Untersuchungen von Neugeborenen- und Fetalseren zur Erfassung von konnatalenToxoplasma-Infektionen. Z. Geburtsh. u. Perinat. 195 (1991) 262–265.
Lappallainen, M.:Toxoplasma infection during pregnancy. A prospective cohort study and a cost-benefit analysis. Thesis. Med. Faculty Univ. Helsinki, 1995, p. 20.
Enders, G.: Toxoplasmose in der Schwangerschaft. In:Shah, W., Stille, W. (eds.): Infektionen durchToxoplasma gondii. Socio-medico Verlag, Gräfelfing 1991, pp. 33–43.
Jacquier, P., Nadal, D., Zuber, P., Eckert, J.: Zur Lage der Infektion mitToxoplasma gondii bei der schweizerischen Bevölkerung: Beitrag einer seroepidemiologischen Studie aus dem Kanton Zürich. Schweiz. Med. Wochenschr. 125 (Suppl. 65) (1995) 23S-28S.
Derouin, F., Thulliez, P., Garin, Y. J.: Interêt et limites de la sérologie de toxoplasmose chez les sujets VIH+. Path. Biol. Paris 39 (1991) 255–259.
Gazzinelli, R. T., Sher, A., Cheever, A., Gerstberger, S., Martin, M. A., Dickie, P.: Infection of human immunodeficiency virus 1 transgenic mice withToxoplasma gondii stimulates proviral transcription in macrophagesin vitro. J. Exp. Med. 183 (1996) 1645–1655.
McCabe, R. E., Remington, J. S.:Toxoplasma gondii. In:Mandell, G. L., Douglas, R. G., Bennet, J. E. (eds.): Principle and practice of infectious diseases. Churchill Livingstone Inc., New York 1990. p. 2090.
Decoster, A.: Detection of IgA anti-P30 (SAG1) antibodies in acquired and congenital toxoplasmosis. in:Groß, U. (eds.):Toxoplasma gondii, Springer Verlag, Berlin Heidelberg 1996, pp. 199–205.
Pinon, J. M., Foudrinier, F., Mougeot, G., Marx, C., Aubert, D., Toupance, O., Niel, G., Danis, M., Camerlynck, P., Remy, G., Frottier, J., Jolly, D., Bessiers, M. H., Richard-Lenoble, D., Bonhomme, A.: Evaluation of risk and diagnostic value of quantitative assays for anti-Toxoplasma gondii immunoglobulin A (IgA), IgE, and IgM and analytical study of specific IgG in immunodeficient patients. J. Clin. Microb. 33 (1995) 878–884.
Hellerbrand, C., Goebel, F. D., Disko, R.: High predictive value ofToxoplasma gondii IgG antibody levels in HIV-infected patients for diagnosis of cerebral toxoplasmosis. Eur. J. Clin. Microbiol. Infect. Dis. 15 (1995) 869–872.
Brindle, R., Holliman, R., Gilks, C., Waiyaki, P.:Toxoplasma antibodies in HIV-positive patients from Nairobi. Trans. R. Soc. Trop. Med. Hyg. 85 (1991) 750–751.
Luyasu, V., Robert, A. R., Schaefer, L., Macioszek, J., Multicenter Study Group Multicenter evaluation of a new commercial assay for detection of immunoglobulin M antibodies toToxoplasma gondii. Eur. J. Microbiol. Infect. Dis. 14 (1995) 787–793.
Simmonds, P., Beatson, D., Cuthbert, R., Watson, H., Reynolds, B., Peutherer, J. F., Parry, J. V., Ludlam, C. A., Stell, C. M.: Determinants of HIV disease progression: six-year longitudinal study in the Edinburgh haemophilia/HIV cohort. Lancet 338 (1991) 1159–1163.
Ammassari, A., Murri, R., Cingolani, A., De Luca, A., Antinori, A.: AIDS-associated cerebral toxoplasmosis: an update on diagnosis and treatment. In:Groß, U. (ed.):Toxoplasma gondii. Springer Verlag, Berlin Heidelberg 1996, pp. 209–220.
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Reiter-Owona, I., Bialek, R., Rockstroh, J.K. et al. The probability of acquiring primaryToxoplasma infection in HIV-infected patients: Results of an 8-year retrospective study. Infection 26, 20–25 (1998). https://doi.org/10.1007/BF02768747
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DOI: https://doi.org/10.1007/BF02768747