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Cats and toxoplasmosis risk in HIV-infected adults
M R Wallace1, R J Rossetti, P E Olson
1Department of Internal Medicine (Infectious Disease Division), US Naval Hospital, San Diego, Calif 92134-5000.
Objective:
To establish the prevalence and incidence of toxoplasmosis in an adult human immunodeficiency virus (HIV) population, and to determine if cat ownership contributes to the risk of toxoplasmosis.
Design:
Retrospective record and laboratory review, coupled with a patient survey.
Setting:
A tertiary-care military hospital HIV program.
Patients:
A total of 723 HIV-infected adults, all former or current US military personnel.
Main Outcome Measures:
Prevalence and incidence of serologic evidence of toxoplasmosis infection.
Results:
A total of 723 HIV-infected patients had serial Toxoplasma IgG antibody determinations. Seventy patients (9.7%) were positive on their initial screen; the seronegative patients were tested annually for 1 to 5 years (mean duration of follow-up, 2.1 years). Only 13 patients (2.0%) who were initially seronegative acquired antibodies to Toxoplasma gondii. None of the patients who seroconverted developed clinical disease. A pet history was available on 12 of 13 patients who seroconverted; only one (8.3%) had owned or lived in a household with a cat during the period of seroconversion. The calculated attributable risk of cat ownership/exposure for toxoplasmosis seroconversion in this population is -2.9 per 100 persons annually.
Conclusion:
Toxoplasma antibody seroconversion in an adult HIV-infected population is unusual and appears unrelated to cat ownership or exposure.