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M9640792.TXT
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1996-03-04
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Document 0792
DOCN M9640792
TI Preventing toxoplasmic encephalitis in persons infected with human
immunodeficiency virus.
DT 9604
AU Richards FO Jr; Kovacs JA; Luft BJ; Division of Parasitic Diseases,
Centers for Disease Control and; Prevention, CDC, Atlanta, Georgia
30333, USA.
SO Clin Infect Dis. 1995 Aug;21 Suppl 1:S49-56. Unique Identifier :
AIDSLINE MED/96002827
AB Toxoplasmic encephalitis (TE) is the second most common AIDS-related
opportunistic infection of the CNS. It occurs in 10%-50% of patients
with AIDS who are seropositive for antibodies to Toxoplasma gondii and
have CD4+ T lymphocyte counts of < 100/mm3. Primary toxoplasmic
infection usually is acquired by ingestion of T. gondii oocysts from
soil contaminated by cat feces or by ingestion of tissue cysts present
in undercooked red meats. In patients with AIDS, TE probably results
from the reactivation of Toxoplasma tissue cysts that remained latent
after the primary infection. Detection of IgG antibodies to Toxoplasma
indicates prior infection and the possible presence of tissue cysts and,
thus, risk for developing TE. A regimen of trimethoprim-sulfamethoxazole
or dapsone plus pyrimethamine with leucovorin is recommended for persons
infected with the human immunodeficiency virus (HIV) and who are
seropositive for IgG to Toxoplasma after their CD4+ T lymphocyte counts
fall to < 100/mm3. HIV-infected persons who are seronegative for IgG to
Toxoplasma should be counseled to protect themselves from primary
toxoplasmic infection by eating only well-cooked meats and washing their
hands after outdoor activities involving soil contact; if they have a
cat, they should feed it only commercial or well-cooked foods, keep it
indoors, and make sure that the litter box is changed daily.
HIV-infected persons who are Toxoplasma seropositive may also be advised
about these preventive behavioral practices.
DE Animal Anti-Infective Agents/THERAPEUTIC USE AIDS-Related
Opportunistic Infections/EPIDEMIOLOGY/*PREVENTION & CONTROL Cats
Dapsone/THERAPEUTIC USE Drug Therapy, Combination
Encephalitis/EPIDEMIOLOGY/*PREVENTION & CONTROL Human Incidence
Leucovorin/THERAPEUTIC USE Pyrimethamine/THERAPEUTIC USE Recurrence
Risk Factors Toxoplasmosis, Animal/EPIDEMIOLOGY Toxoplasmosis,
Cerebral/EPIDEMIOLOGY/*PREVENTION & CONTROL
Trimethoprim-Sulfamethoxazole Combination/THERAPEUTIC USE United
States/EPIDEMIOLOGY JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).