What is the prevalence of CNS toxoplasmosis in HIV infection?

Updated: Jul 11, 2017
  • Author: Gulshan Uppal, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Clinical CNS toxoplasmosis occurs in 3-15% of patients with AIDS in the United States. Some clinically silent lesions come to diagnosis only at autopsy. Clinical CNS toxoplasmosis occurs in as many as 50-75% of patients in some European countries and in Africa.

The probability of developing reactivated toxoplasmosis is as high as 30% among AIDS patients with a CD4 count <100 cells/microL who are toxoplasma seropositive and are not receiving effective prophylaxis or antiretroviral therapy. The most common site of reactivation is the central nervous system (CNS). [2]

Recently in a epidemiologic study in Mexico city with 320 patients AIDS patients, the main conditions related to HIV/AIDS were brain toxoplasmosis (42%), cerebral cryptococcosis (28%), tuberculous meningitis (8.7%), lymphoma (non-Hodgkin) (3.75%), acute HIV infection (3.4%), and AIDS dementia complex (3%). [3]

The widespread use of antiretroviral treatment has decreased the incidence of toxoplasmic encephalitis. As an example, among HIV-infected patients in the United States, the annual number of toxoplasmosis-related hospitalizations peaked at more than 10,000 in 1995, dropped sharply to 3643 in 2001, and then decreased to 2985 in 2008. [4]


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