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Published on: November 3, 2009
Cerebral toxoplasmosis in the twenty-first century
C M van Deuzen1,2, B J A Rijnders1,2, H I Bax1,2
1Department of Medical Microbiology & Infectious Diseases.
Background:
Cerebral toxoplasmosis is a common opportunistic infection in people with HIV (PWH), associated with high morbidity and mortality. It is unclear how clinical characteristics, treatment response and long-term clinical outcomes in PWH with cerebral toxoplasmosis have changed due to improved treatment of HIV.
Methods:
This single-centre retrospective observational cohort study of PWH with cerebral toxoplasmosis included patients over almost 25 years.
Results:
Sixty-three eligible patients were identified. Most patients were late presenters presenting with headache and neurological symptoms. Overall survival was 79% over a mean follow up of 15 years. Seventy-three percent of deaths occurred within the first year after diagnosis. Almost 10% of patients experienced residual impairments.
Conclusion:
An earlier diagnosis of HIV reduces the incidence of cerebral toxoplasmosis due to timely initiation of combination antiretroviral therapy (cART) and anti- Toxoplasma prophylaxis. High index of suspicion by clinicians is vital to timely start anti- Toxoplasma therapy. If treated correctly and timely, overall survival is high.
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