Incidence, Immunological and Clinical Characteristics of Reactivation of Latent Toxoplasma Gondii Infection in HIV-infected Patients

Overview

Journal Epidemiol Infect

Publisher Cambridge University Press

Specialties Infectious Diseases
Public Health

Date 2014 May 23

PMID 24850323

Citations 30

Authors

P Kodym

M Maly

O Beran

D Jilich

H Rozsypal

L Machala

M Holub

Affiliations

Soon will be listed here.

Abstract

To determine changes in incidence of reactivation of Toxoplasma gondii infection, manifesting as toxoplasmic encephalitis, and to assess the immunological mechanisms controlling reactivation in HIV-infected patients, a Czech cohort of 502 HIV/T. gondii co-infected patients was followed for 2909·3 person-years. The incidence of toxoplasmic encephalitis between the periods before and after the introduction of combination antiretroviral therapy (cART) was compared. Toxoplasmic encephalitis was diagnosed in 21 patients. In those patients the geometric mean value of CD4+ T lymphocytes was 12·6 times lower than in patients with non-reactivated T. gondii infection but an additionally significant decline in CD8+ T lymphocytes (3·3-fold) and natural killer cells (4·3-fold) was observed. This confirms the significance of these parameters. A twelvefold decrease in Toxoplasma reactivation incidence (40·2 vs. 3·4/1000 person-years) between monitored periods was seen. In the cART era, Toxoplasma reactivation was observed only in patients with unrecognized HIV infection or refusing therapy.

Citing Articles

Development of a LAMP method with lateral flow DNA chromatography to diagnose toxoplasmosis in immunocompromised patients.

Mikita K, Mori T, Komine T, Kobayashi S, Iwata S, Suzuki K Trop Med Health. 2024; 52(1):45.

PMID: 38978129 PMC: 11229303. DOI: 10.1186/s41182-024-00613-4.

Imiquimod Reverses Chronic Toxoplasmosis-Associated Behavioral and Neurocognitive Anomalies in a Rat Model.

Itani S, Hamie M, El Jammal R, Abdine W, Doumit M, Charafeddine A Biomedicines. 2024; 12(6).

PMID: 38927503 PMC: 11202296. DOI: 10.3390/biomedicines12061295.

Seroprevalence of among HIV Positive Patients under Surveillance in Greek Infectious Disease Units: A Screening Study with Comparative Evaluation of Serological Methods.

Voyiatzaki C, Zare Chormizi A, Tsoumani M, Efstathiou A, Konstantinidis K, Chaniotis D Pathogens. 2024; 13(5).

PMID: 38787227 PMC: 11123859. DOI: 10.3390/pathogens13050375.

Diabetic Retinopathy during pregnancy in Hispanic women with latent Toxoplasma gondii infection.

Elliott A, Ng J, Ojeleye M, Cuadros J, Prescott S, Bruder K Eur J Obstet Gynecol Reprod Biol. 2024; 294:28-32.

PMID: 38184897 PMC: 11344265. DOI: 10.1016/j.ejogrb.2024.01.001.

Tryptophan metabolism and immune alterations in pregnant Hispanic women with chronic Toxoplasma gondii infection.

Prescott S, Mutka T, Baumgartel K, Yoo J, Morgan H, Postolache T Am J Reprod Immunol. 2023; 90(3):e13768.

PMID: 37641377 PMC: 10538252. DOI: 10.1111/aji.13768.

References

Rabaud C, May T, Amiel C, Katlama C, Leport C, Ambroise-Thomas P . Extracerebral toxoplasmosis in patients infected with HIV. A French National Survey. Medicine (Baltimore). 1994; 73(6):306-14. DOI: 10.1097/00005792-199411000-00004. View

Denkers E, Gazzinelli R, Martin D, Sher A . Emergence of NK1.1+ cells as effectors of IFN-gamma dependent immunity to Toxoplasma gondii in MHC class I-deficient mice. J Exp Med. 1993; 178(5):1465-72. PMC: 2191244. DOI: 10.1084/jem.178.5.1465. View

Bertschy S, Opravil M, Cavassini M, Bernasconi E, Schiffer V, Schmid P . Discontinuation of maintenance therapy against toxoplasma encephalitis in AIDS patients with sustained response to anti-retroviral therapy. Clin Microbiol Infect. 2006; 12(7):666-71. DOI: 10.1111/j.1469-0691.2006.01459.x. View

Machala L, Maly M, Beran O, Jilich D, Kodym P . Incidence and clinical and immunological characteristics of primary Toxoplasma gondii infection in HIV-infected patients. Int J Infect Dis. 2013; 17(10):e892-6. DOI: 10.1016/j.ijid.2013.03.017. View

Girard P, Landman R, Olivares R, Saimot A, Jelazko P, Gaudebout C . Dapsone-pyrimethamine compared with aerosolized pentamidine as primary prophylaxis against Pneumocystis carinii pneumonia and toxoplasmosis in HIV infection. The PRIO Study Group. N Engl J Med. 1993; 328(21):1514-20. DOI: 10.1056/NEJM199305273282102. View

Jones J, Hanson D, Chu S, Ciesielski C, Kaplan J, Ward J . Toxoplasmic encephalitis in HIV-infected persons: risk factors and trends. The Adult/Adolescent Spectrum of Disease Group. AIDS. 1996; 10(12):1393-9. DOI: 10.1097/00002030-199610000-00012. View

Bachmeyer C, Mouchnino G, Thulliez P, Blum L . Congenital toxoplasmosis from an HIV-infected woman as a result of reactivation. J Infect. 2005; 52(2):e55-7. DOI: 10.1016/j.jinf.2005.05.004. View

Bhadra R, Khan I . Redefining chronic toxoplasmosis--a T cell exhaustion perspective. PLoS Pathog. 2012; 8(10):e1002903. PMC: 3469626. DOI: 10.1371/journal.ppat.1002903. View

Israelski D, Remington J . Toxoplasmic encephalitis in patients with AIDS. Infect Dis Clin North Am. 1988; 2(2):429-45. View

10.

Derouin F, Thulliez P, Garin Y . [Value and limitations of toxoplasmosis serology in HIV patients]. Pathol Biol (Paris). 1991; 39(4):255-9. View

11.

Gazzinelli R, Hieny S, Wynn T, Wolf S, Sher A . Interleukin 12 is required for the T-lymphocyte-independent induction of interferon gamma by an intracellular parasite and induces resistance in T-cell-deficient hosts. Proc Natl Acad Sci U S A. 1993; 90(13):6115-9. PMC: 46878. DOI: 10.1073/pnas.90.13.6115. View

12.

Dreux S, Rousseau T, Gerber S, Col J, Dommergues M, Muller F . Fetal serum beta2-microglobulin as a marker for fetal infectious diseases. Prenat Diagn. 2006; 26(5):471-4. DOI: 10.1002/pd.1441. View

13.

Montoya J . Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis. J Infect Dis. 2002; 185 Suppl 1:S73-82. DOI: 10.1086/338827. View

14.

Israelski D, Chmiel J, Poggensee L, Phair J, Remington J . Prevalence of Toxoplasma infection in a cohort of homosexual men at risk of AIDS and toxoplasmic encephalitis. J Acquir Immune Defic Syndr (1988). 1993; 6(4):414-8. View

15.

Meers S, Lagrou K, Theunissen K, Dierickx D, Delforge M, Devos T . Myeloablative conditioning predisposes patients for Toxoplasma gondii reactivation after allogeneic stem cell transplantation. Clin Infect Dis. 2010; 50(8):1127-34. DOI: 10.1086/651266. View

16.

Bossi P, Caumes E, Astagneau P, Li T, Paris L, Mengual X . [Epidemiologic characteristics of cerebral toxoplasmosis in 399 HIV-infected patients followed between 1983 and 1994]. Rev Med Interne. 1998; 19(5):313-7. DOI: 10.1016/s0248-8663(98)80100-8. View

17.

Moore R, Chaisson R . Natural history of HIV infection in the era of combination antiretroviral therapy. AIDS. 1999; 13(14):1933-42. DOI: 10.1097/00002030-199910010-00017. View

18.

Mateen F, Shinohara R, Carone M, Miller E, McArthur J, Jacobson L . Neurologic disorders incidence in HIV+ vs HIV- men: Multicenter AIDS Cohort Study, 1996-2011. Neurology. 2012; 79(18):1873-80. PMC: 3525315. DOI: 10.1212/WNL.0b013e318271f7b8. View

19.

Gazzinelli R, Hakim F, Hieny S, Shearer G, Sher A . Synergistic role of CD4+ and CD8+ T lymphocytes in IFN-gamma production and protective immunity induced by an attenuated Toxoplasma gondii vaccine. J Immunol. 1991; 146(1):286-92. View

20.

Happe S, Fischer A, Heese C, Reichelt D, Gruneberg U, Freund M . [HIV-associated cerebral toxoplasmosis -- review and retrospective analysis of 36 patients]. Nervenarzt. 2002; 73(12):1174-8. DOI: 10.1007/s00115-002-1416-y. View