Abstract
Objectives:
We compared clinical long-term course and outcome in all AIDS patients admitted to our outpatient department from January, 1989 to June, 1998 with toxoplasma encephalitis (TE) as first AIDS-defining infection (n= 106) and in 106 patients with Pneumocystis carinii pneumonia (PCP) as first AIDS-defining disease.
Material and methods:
The 2 groups were matched with respect to age, sex, risk group, degree of immunodeficiency as measured by CD4 cell counts and duration of HIV-1-positivity. TE was diagnosed radiologically and by response to treatment.
Results:
Forty-three TE patients surviving the first TE symptoms > 14 months developed dementive symptoms, leucoencephalopathy in imaging procedures and died from dementia. In contrast only 5 patients surviving PCP for an equally long period showed dementive symptoms.
Conclusion:
Cerebral infections like toxoplasma encephalitis (TE) may negatively influence HIV-1-activity so far latent in the brain.
Publication types
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Comparative Study
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Research Support, Non-U.S. Gov't
MeSH terms
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AIDS Dementia Complex / diagnostic imaging
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AIDS Dementia Complex / parasitology
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AIDS Dementia Complex / therapy*
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AIDS-Related Opportunistic Infections / drug therapy
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AIDS-Related Opportunistic Infections / parasitology
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AIDS-Related Opportunistic Infections / therapy*
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Adult
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Anti-Bacterial Agents / administration & dosage
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Antiprotozoal Agents / administration & dosage
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Clindamycin / administration & dosage
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Female
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Hospitalization
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Humans
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Leukocytosis / cerebrospinal fluid
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Leukocytosis / virology
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Magnetic Resonance Imaging
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Male
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Middle Aged
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Pneumonia, Pneumocystis / therapy
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Pyrimethamine / administration & dosage
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Sulfonamides / administration & dosage
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Survival Analysis
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Tomography, X-Ray Computed
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Toxoplasmosis, Cerebral / drug therapy
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Toxoplasmosis, Cerebral / mortality
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Toxoplasmosis, Cerebral / therapy*
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Treatment Outcome
Substances
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Anti-Bacterial Agents
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Antiprotozoal Agents
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Sulfonamides
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Clindamycin
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Pyrimethamine