Cerebral toxoplasmosis in HIV-infected patients: a review.

Pathog Glob Health

Parasitology Division, Department of Biomedical Sciences, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.

Published: February 2023

infection in the central nervous system commonly occurs among immunodeficient patients. Its prevalence is high in countries with a high burden of HIV and low coverage of antiretroviral drugs. The brain is one of the predilections for infection due to its low inflammatory reaction, and cerebral toxoplasmosis occurs solely due to the reactivation of a latent infection rather than a new infection. Several immune elements have recently been recognized to have an essential role in the immunopathogenesis of cerebral toxoplasmosis. Although real-time isothermal amplification, next-generation sequencing, and enzyme-linked aptamer assays from blood samples have been the recommended diagnostic tools in some in-vivo studies, a combination of clinical symptoms, serology examination, and neuroimaging are still the daily standard for the presumptive diagnosis of cerebral toxoplasmosis and early anti-toxoplasma administration. Clinical trials are needed to find a new therapy that is less likely to affect folate synthesis, have neuroprotective properties, or cure the latent phase of infection. The development of a vaccine is being extensively tested in animals, but its efficacy and safety for humans are still not proven.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9848325PMC
http://dx.doi.org/10.1080/20477724.2022.2083977DOI Listing

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  • A 55-year-old woman with HIV/AIDS, adhering to her antiretroviral therapy, was hospitalized due to swallowing difficulties and swollen lymph nodes, revealing a rare case of disseminated histoplasmosis and suspected cerebral toxoplasmosis.
  • The diagnosis was confirmed through various tests, including a biopsy, (1-3) -β-glucan assay, and imaging studies.
  • This case underscores the challenges of managing opportunistic infections during immune recovery in HIV patients and the importance of vigilant monitoring and comprehensive diagnostics.
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