TY - JOUR

T1 - Cerebral toxoplasmosis in HIV-infected patients over 2015-2018 (a case study of Russia)

AU - Azovtseva, O. V.

AU - Bakulina, C. G.

AU - Shelomov, A. S.

AU - Trofimova, T. N.

N1 - Publisher Copyright: © 2020 Cambridge University Press. All rights reserved. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020

Y1 - 2020

N2 - Cerebral toxoplasmosis is a leading cause of the central nervous system disorders in acquired immune deficiency syndrome (AIDS). This study aimed to investigate the clinical course of cerebral toxoplasmosis in human immunodeficiency virus (HIV)-infected individuals. The study included 90 HIV-infected patients with cerebral toxoplasmosis, who underwent inpatient treatment. In case of positive enzyme immunoassay, HIV infection was confirmed with the immunoblot test. The HIV-1 ribonucleic acid (RNA) level was determined using the polymerase chain reaction (PCR) method. The flow cytometry was used for counting CD4 (cluster of differentiation 4 cells). Pathomorphological examination included the autopsy, gross and microscopic examination of internal organs, histological and other methods. The incidence of cerebral toxoplasmosis significantly increases at the CD4 count below 100 cells/μl, p <0.001, and at the HIV viral load above 50 copies/ml, p <0.05. The clinical picture of cerebral toxoplasmosis included focal symptoms, cognitive impairment, toxic syndrome, mild cerebral symptoms, and a meningeal symptom. Given the absence of a specific clinical picture and the absence of abnormal laboratory and instrumental findings, the cerebral toxoplasmosis needs to be diagnosed with a number diagnostic methods combined: Clinical examination, laboratory testing, immunological examination, molecular genetic testing, and neuroradiological imaging.

AB - Cerebral toxoplasmosis is a leading cause of the central nervous system disorders in acquired immune deficiency syndrome (AIDS). This study aimed to investigate the clinical course of cerebral toxoplasmosis in human immunodeficiency virus (HIV)-infected individuals. The study included 90 HIV-infected patients with cerebral toxoplasmosis, who underwent inpatient treatment. In case of positive enzyme immunoassay, HIV infection was confirmed with the immunoblot test. The HIV-1 ribonucleic acid (RNA) level was determined using the polymerase chain reaction (PCR) method. The flow cytometry was used for counting CD4 (cluster of differentiation 4 cells). Pathomorphological examination included the autopsy, gross and microscopic examination of internal organs, histological and other methods. The incidence of cerebral toxoplasmosis significantly increases at the CD4 count below 100 cells/μl, p <0.001, and at the HIV viral load above 50 copies/ml, p <0.05. The clinical picture of cerebral toxoplasmosis included focal symptoms, cognitive impairment, toxic syndrome, mild cerebral symptoms, and a meningeal symptom. Given the absence of a specific clinical picture and the absence of abnormal laboratory and instrumental findings, the cerebral toxoplasmosis needs to be diagnosed with a number diagnostic methods combined: Clinical examination, laboratory testing, immunological examination, molecular genetic testing, and neuroradiological imaging.

KW - Cerebral toxoplasmosis

KW - Clinical picture

KW - HIV infection

KW - Medical imaging

KW - Pathoanatomy

KW - Humans

KW - Male

KW - Viral Load

KW - HIV Infections/complications

KW - Adult

KW - Female

KW - Russia/epidemiology

KW - AIDS-Related Opportunistic Infections/epidemiology

KW - Toxoplasmosis, Cerebral/complications

KW - pathoanatomy

KW - clinical picture

KW - medical imaging

UR - http://www.scopus.com/inward/record.url?scp=85086237920&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/623ec986-b2d6-3e34-902c-9cea6ff15fa9/

U2 - 10.1017/S0950268820000928

DO - 10.1017/S0950268820000928

M3 - Article

C2 - 32364106

AN - SCOPUS:85086237920

VL - 148

JO - Epidemiology and Infection

JF - Epidemiology and Infection

SN - 0950-2688

M1 - 142

ER -