Importance of high IgG anti-Toxoplasma gondii titers and PCR detection of T. gondii DNA in peripheral blood samples for the diagnosis of AIDS-related cerebral toxoplasmosis: a case-control study
Braz. j. infect. dis
;
15(4): 356-359, July-Aug. 2011. tab
Article
Dans Anglais
| LILACS, SES-SP
| ID: lil-595677
ABSTRACT
BACKGROUND:
Cerebral toxoplasmosis (CT) continues to cause significant morbidity and mortality in human immunodeficiency virus (HIV)-infected patients in Brazil. In clinical practice, the initial diagnosis is usually presumptive and alternative diagnosis tools are necessary. Our objective was to evaluate whether the detection of high titers of IgG anti-Toxoplasma gondii and T. gondii DNA in blood samples are associated with the diagnosis of CT.METHODS:
In this case-control study we included 192 patients with HIV-1 infection 64 patients with presumptive CT (cases) and 128 patients with other diseases (controls). Blood samples to perform indirect immunofluorescense reaction (IFI) to detect anti-T. gondii IgG antibodies and polymerase chain reaction (PCR) were collected before or within the first three days of anti-Toxoplasma therapy. Two multivariate logistic regression models were performed one including the variable qualitative serology and another including quantitative serology.RESULTS:
In the first model, positive IgG anti-T. gondii (OR 4.7, 95 percent CI 1.2-18.3; p = 0.027) and a positive T. gondii PCR result (OR 132, 95 percent CI 35-505; p < 0.001) were associated with the diagnosis. In the second model, IgG anti-T. gondii titres > 11024 (OR 7.6, 95 percent CI 2.3-25.1; p = 0.001) and a positive T. gondii PCR result (OR 147, 95 percent CI 35-613; p < 0.001) were associated with the diagnosis.CONCLUSIONS:
Quantitative serology and molecular diagnosis in peripheral blood samples were independently associated with the diagnosis of CT in HIV-infected patients. These diagnostic tools can contribute to a timely diagnosis of CT in settings where Toxoplasma infection is common in the general population.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Toxoplasma
/
Immunoglobuline G
/
Anticorps antiprotozoaires
/
ADN des protozoaires
/
Toxoplasmose cérébrale
/
Infections opportunistes liées au SIDA
Type d'étude:
Etude diagnostique
/
Étude observationnelle
/
Étude pronostique
/
Recherche qualitative
/
Facteurs de risque
Limites du sujet:
Adulte
/
Femelle
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Braz. j. infect. dis
Année:
2011
Type:
Article
Institution/Pays d'affiliation:
Instituto Adolfo Lutz/BR
/
Instituto de Infectologia Emílio Ribas/BR
/
Lerner Research Institute/US
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