Long-term course and outcome in AIDS patients with cerebral toxoplasmosis.
OBJECTIVE
We compared clinical long-term course and outcome in all AIDS patients admitted to our outpatient department from January, 1989 to June, 1998 with toxoplasma encephalitis (TE) as first AIDS-defining infection (n= 106) and in 106 patients with Pneumocystis carinii pneumonia (PCP) as first AIDS-defining disease.


METHODS
The 2 groups were matched with respect to age, sex, risk group, degree of immunodeficiency as measured by CD4 cell counts and duration of HIV-1-positivity. TE was diagnosed radiologically and by response to treatment.


RESULTS
Forty-three TE patients surviving the first TE symptoms > 14 months developed dementive symptoms, leucoencephalopathy in imaging procedures and died from dementia. In contrast only 5 patients surviving PCP for an equally long period showed dementive symptoms.


CONCLUSIONS
Cerebral infections like toxoplasma encephalitis (TE) may negatively influence HIV-1-activity so far latent in the brain.
Arendt
G
G
Department of Neurology, Heinrich-Heine University Düsseldorf, Germany.
von Giesen
H J
HJ
Hefter
H
H
Neuen-Jacob
E
E
Roick
H
H
Jablonowski
H
H
D015526:AIDS Dementia Complex / Q000000981:diagnostic imaging / Q000469:parasitology / Q000628:therapy*; D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000469:parasitology / Q000628:therapy*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000981:Antiprotozoal Agents / Q000008:administration & dosage; D002981:Clindamycin / Q000008:administration & dosage; D005260:Female; D006760:Hospitalization; D006801:Humans; D007964:Leukocytosis / Q000134:cerebrospinal fluid / Q000821:virology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000628:therapy; D011739:Pyrimethamine / Q000008:administration & dosage; D013449:Sulfonamides / Q000008:administration & dosage; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016781:Toxoplasmosis, Cerebral / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000981:Antiprotozoal Agents; D013449:Sulfonamides; D002981:Clindamycin; D011739:Pyrimethamine