[Prevention of toxoplasmosis in immunocompromised patients].
The main underlying immunosuppressive conditions requiring prevention of toxoplasmosis are organ transplantations (especially heart and bone marrow transplants) and advanced HIV infection (CD4 + lymphocytes count < 100/mm3). Preventive strategies consist in reducing the rate of primary infection, mainly through hygiene and diet measures, and introducing chemoprophylaxis in patients already contaminated by the parasite: the most precise knowledge in this field concerns HIV infected patients. For prevention of recurrence, patients should receive pyrimethamine-sulfadiazine, or otherwise pyrimethamine-clindamycin combinations. For primary prophylaxis, cotrimoxazole is the first-line therapy. If patients cannot tolerate cotrimoxazole, a regiment including dapsone plus pyrimethamine is a possible alternative; pyrimethamine alone and atovaquone are currently under investigation.
Morlat
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Service de Médecine Interne, Hôpital Saint-André, Bordeaux.
Leport
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C
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D006801:Humans; D016867:Immunocompromised Host; D016377:Organ Transplantation / Q000009:adverse effects; D012307:Risk Factors; D014123:Toxoplasmosis / Q000517:prevention & control*
La prophylaxie de la toxoplasmose chez les patients immunodéprimés.