Long-term course and outcome in AIDS patients with cerebral toxoplasmosis

Acta Neurol Scand. 1999 Sep;100(3):178-84. doi: 10.1111/j.1600-0404.1999.tb00735.x.

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

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS Dementia Complex / diagnostic imaging
  • AIDS Dementia Complex / parasitology
  • AIDS Dementia Complex / therapy*
  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / parasitology
  • AIDS-Related Opportunistic Infections / therapy*
  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Antiprotozoal Agents / administration & dosage
  • Clindamycin / administration & dosage
  • Female
  • Hospitalization
  • Humans
  • Leukocytosis / cerebrospinal fluid
  • Leukocytosis / virology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pneumonia, Pneumocystis / therapy
  • Pyrimethamine / administration & dosage
  • Sulfonamides / administration & dosage
  • Survival Analysis
  • Tomography, X-Ray Computed
  • Toxoplasmosis, Cerebral / drug therapy
  • Toxoplasmosis, Cerebral / mortality
  • Toxoplasmosis, Cerebral / therapy*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Antiprotozoal Agents
  • Sulfonamides
  • Clindamycin
  • Pyrimethamine