How is CNS toxoplasmosis prevented in patients with 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

Answer

To prevent primary toxoplasmosis, patients should avoid eating undercooked meat and should wash their hands carefully after contact with soil or cats. Patients who are seropositive for Toxoplasma should be started on prophylaxis against CNS toxoplasmosis if their CD4+ count drops below 100 cells/μL. [1]

The preferred prophylactic regimen is one double-strength tablet of trimethoprim-sulfamethoxazole (TMP-SMZ) daily, which also provides prophylaxis against Pneumocystis jiroveci pneumonia (PCP). [1] An alternative regimen is one double-strength TMP-SMZ tablet 3 times weekly. The recommended alternative for patients who cannot tolerate TMP-SMZ is dapsone-pyrimethamine plus leucovorin, which is also effective against PCP.


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