Toxoplasmic encephalitis in an HIV infected pregnant woman: successful outcome for both mother and child.
This report describes a case of Toxoplasma encephalitis during pregnancy of an HIV infected woman who was severely immunosuppressed (CD(4): 17 cells/mm3), had a high viral load (RNA PCR:230,000 copies/ml), was treated with sulfadiazine, pyrimethamine and folinic acid for toxoplasmosis and was being treated with highly potent antiretroviral drugs (AZT, 3TC and nelfinavir) for HIV infection. The newborn was born through an elective C-section, received six weeks of AZT according to the 076 protocol and was clinically normal at birth. Subsequently he had two RNA PCR negatives for HIV, seroreverted and had no clinical or laboratory evidence of congenital toxoplasmosis. Despite the concerns of the use of these combined therapies on the foetus during pregnancy, their efficacy illustrates that keeping the mother alive and in good health is an important strategy to protect the unborn child from acquiring these two infections.
Clementino Fraga Filho Hospital, Federal University of Rio de Janeiro, Hospital of Lagoa, Rio de Janeiro, RJ, Brazil. susie@hucff.ufrj.br
Susie Andries
SA
Nogueira
Ana Lúcia
AL
Guedes
Elizabeth S
ES
Machado
Juliana A
JA
Matos
Tomás P
TP
Costa
Ely M
EM
Cortes
John S
JS
Lambert
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000469:parasitology* / Q000635:transmission; D000328:Adult; D000818:Animals; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000635:transmission* / Q000821:virology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy / Q000469:parasitology / Q000821:virology; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000469:parasitology / Q000821:virology; D014122:Toxoplasma / Q000302:isolation & purification; D016781:Toxoplasmosis, Cerebral / Q000150:complications* / Q000188:drug therapy* / Q000635:transmission; D016896:Treatment Outcome; D019562:Viral Load
D019380:Anti-HIV Agents