title: Toxoplasma gondii antibody profile in HIV-1-infected and uninfected pregnant women and the impact on congenital toxoplasmosis diagnosis in Rio de Janeiro, Brazil.
abstract: OBJECTIVE
  Compare the anti-T. gondii IgG titer between HIV-1 infected and non HIV-1 infected pregnant women and report three cases of congenital toxoplasmosis resulting from reactivation of infection during pregnancy of HIV-1 infected women.
  
  
  METHODS
  This study was conducted among 2,270 pregnant women with chronic Toxoplasma gondii infection (absence of IgM and presence of IgG), including 82 HIV-1 infected and 2,188 non-infected women.
  
  
  RESULTS
  The average anti-T. gondii IgG titer was 127 for the 2,188 non-HIV-1 infected women, and 227 for the 82 HIV-1-infected women (p = 0,007). These results suggested that higher anti-T. gondii IgG titers in HIV-1-infected pregnant women may not be indicative of an elevated risk for fetal infection. In this study three cases of congenital toxoplasmosis that resulted from infection reactivation during pregnancy of HIV-1-infected women were manifested by fetal death, symptomatic infection, and infant without symptoms, respectively. In two of these women, a ten-fold increase in IgG levels above used cutoff was observed (2,320 UI/mL and 3,613 UI/mL, respectively). In the third pregnant women anti-T. gondii IgG titers during pregnancy did not rise despite the occurrence of congenital toxoplasmosis (204; 198; 172 UI/mL).
  
  
  CONCLUSIONS
  Congenital toxoplasmosis resulting reactivation of infection during pregnancy in the studied group leads us to believe that it is a public health problem, especially in our population, in which seroprevalence of T. gondii infections is high. These findings also suggest that special attention is necessary during pregnancy, because the serologic diagnosis may not be indicative of toxoplasmosis reactivation.
authors.affiliation: Maternal and Child Department, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Márcia Antunes
authors.initials: MA
authors.lastname: Fernandes
authors.forename: Giovanni Inácio
authors.initials: GI
authors.lastname: Batista
authors.forename: Juliano da Costa Silveira
authors.initials: Jda C
authors.lastname: Carlos
authors.forename: Ivete Martins
authors.initials: IM
authors.lastname: Gomes
authors.forename: Kátia Martins Lopes de
authors.initials: KM
authors.lastname: Azevedo
authors.forename: Sérgio
authors.initials: S
authors.lastname: Setúbal
authors.forename: Solange Artimos de
authors.initials: SA
authors.lastname: Oliveira
authors.forename: Luis Guilhermo Coca
authors.initials: LG
authors.lastname: Velarde
authors.forename: Claudete Aparecida Araújo
authors.initials: CA
authors.lastname: Cardoso
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000469:parasitology*; D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood*; D018791:CD4 Lymphocyte Count; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000469:parasitology*; D012189:Retrospective Studies; D012307:Risk Factors; D014122:Toxoplasma / Q000276:immunology*; D014123:Toxoplasmosis / Q000276:immunology / Q000635:transmission*; D014125:Toxoplasmosis, Congenital / Q000175:diagnosis* / Q000276:immunology; D019562:Viral Load; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D007074:Immunoglobulin G