Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era.
J Infect
; 75(3): 263-273, 2017 09.
Article
em En
| MEDLINE
| ID: mdl-28579301
ABSTRACT
BACKGROUND:
HIV-associated incidence and prognosis of cerebral toxoplasmosis (CTX) is not well established during later years.METHODS:
From the Danish HIV Cohort Study, we identified 6325 HIV-infected individuals. We assessed incidence, mortality, predictive and prognostic factors of CTX during the pre-combination antiretroviral therapy (pre-cART; 1995-1996) and cART-era (1997-2014). Adjusted incidence rate ratios (aIRR), mortality rate ratios (aMRR) and 95% confidence intervals (CI) were assessed using Poisson regression analysis.RESULTS:
CTX IR was 1.17/1000 PYR (95% CI 0.93-1.47). We observed no change in CTX-risk in the first year after HIV-diagnosis, but a substantial reduction in mortality in the first 3 months after CTX diagnosis when comparing the cART-era to the pre-cART-era; {(aIRR 0.79; 95% CI 0.37-1.72) (aMRR 0.15; 95% CI 0.06-0.38)}. For individuals surviving the first year after HIV-diagnosis or the first 3 months after CTX-diagnosis, IRR and MRR had declined to minimal levels {(aIRR 0.06; 95% CI 0.03-0.10); (aMRR 0.02; 95% CI 0.01-0.05)}. Three years after CTX-diagnosis 30% of the patients still had neurological deficits.CONCLUSION:
Although, CTX remains an important cause of morbidity and mortality in the cART-era, with high prevalence of neurological sequelae, incidence and mortality has largely declined, especially among those surviving the first year after diagnosis.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Toxoplasmose Cerebral
/
Infecções Oportunistas Relacionadas com a AIDS
/
Fármacos Anti-HIV
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Infect
Ano de publicação:
2017
Tipo de documento:
Article