Molecular diagnosis of Toxoplasma gondii infection in cerebrospinal fluid from AIDS patients.
BACKGROUND
Toxoplasmic encephalitis (TE) is one of the most common opportunistic infections in immunocompromised patients. In Cuba, despite the highly active antiretroviral therapy, TE is still the most important cause of cerebral mass lesions in patients infected with the human immunodeficiency virus (HIV). The detection of Toxoplasma gondii by PCR may facilitate the diagnosis and follow-up of TE in acquired immunodeficiency syndrome (AIDS) patients by direct identification of parasite DNA in clinical samples. The aim of the present study was to evaluate a rapid PCR method using the B1 gene to detect T. gondii in cerebrospinal fluid (CSF) samples from patients with suspected TE.


METHODS
CSF samples from AIDS and HIV-negative patients were analyzed. Patients were divided into two groups according to the Centre for Disease Control and Prevention (CDC) criteria for AIDS-related TE: AIDS patients with suspected neurotoxoplasmosis and AIDS and HIV-negative patients with other confirmed neurological diseases but no suspicions of TE. Predictive values, diagnostic accuracy, sensitivity and specificity of the PCR B1 method were calculated.


RESULTS
The results obtained from 190 patients showed that this assay has a good sensitivity and specificity (83.3% and 95.7%, respectively) for the diagnosis of TE in AIDS patients.


CONCLUSIONS
PCR using the B1 gene and B22/B23 set of primers is a single, rapid and reliable method that may be valuable for discrimination between toxoplasmosis and other central nervous system (CNS) diseases.
Alfonso
Yenisey
Y
Parasitology Department, Institute of Tropical Medicine 'Pedro Kourí', PO Box 601, Marianao 13, Ciudad de La Habana, Cuba. fraga@ipk.sld.cu.
Fraga
Jorge
J
Fonseca
Carlos
C
Jiménez
Narciso
N
Pinillos
Taimy
T
Dorta-Contreras
Alberto J
AJ
Cox
Raymundo
R
Capó
Virginia
V
Pomier
Olga
O
Bandera
Francisco
F
Ginorio
Dora
D