Toxoplasma gondii infection in advanced HIV infection.
AIDS
; 8(4): 483-7, 1994 Apr.
Article
em En
| MEDLINE
| ID: mdl-8011251
ABSTRACT
OBJECTIVE:
To study Toxoplasma encephalitis (TE) in advanced HIV infection, including predictive factors, possible prophylactic regimens and impact on survival.DESIGN:
Epidemiological analysis of data collected prospectively during the Alpha study, a double-blind, randomized clinical trial, comparing two doses of dideoxyinosine in patients with advanced HIV disease. PATIENTS First episode of TE occurred in 75 out of 499 patients participating in the trial.METHODS:
Kaplan-Meier estimates and semi-parametric Cox's model were used.RESULTS:
A low CD4 cell count and a positive Toxoplasma serology were strongly predictive of the occurrence of TE. In patients with CD4 counts < 100 x 10(6)/l and a positive Toxoplasma serology at entry to the study, the 12-month TE incidence was 25.4%. Patients who were receiving at entry any of the following potentially antitoxoplasmic drugs trimethoprim-sulphamethoxazole, pyrimethamine, dapsone, pyrimethamine-sulphadoxine or sulphadiazine, had a lower TE incidence than those who were not; 6.2 versus 18.8%, respectively (P < 0.001). The rate of survival 12 months after TE was 29.6%. Even after adjusting the major prognostic covariates, TE was predictive of death (P < 0.001; relative risk, 1.8).CONCLUSIONS:
The high HIV incidence, morbidity and mortality in high-prevalence areas suggests that primary prophylaxis should be given in patients at high risk for toxoplasmic reactivation.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Toxoplasmose
/
Toxoplasmose Cerebral
/
Infecções Oportunistas Relacionadas com a AIDS
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
AIDS
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
1994
Tipo de documento:
Article
País de afiliação:
França