       Document 0792
 DOCN  M9640792
 TI    Preventing toxoplasmic encephalitis in persons infected with human
       immunodeficiency virus.
 DT    9604
 AU    Richards FO Jr; Kovacs JA; Luft BJ; Division of Parasitic Diseases,
       Centers for Disease Control and; Prevention, CDC, Atlanta, Georgia
       30333, USA.
 SO    Clin Infect Dis. 1995 Aug;21 Suppl 1:S49-56. Unique Identifier :
       AIDSLINE MED/96002827
 AB    Toxoplasmic encephalitis (TE) is the second most common AIDS-related
       opportunistic infection of the CNS. It occurs in 10%-50% of patients
       with AIDS who are seropositive for antibodies to Toxoplasma gondii and
       have CD4+ T lymphocyte counts of < 100/mm3. Primary toxoplasmic
       infection usually is acquired by ingestion of T. gondii oocysts from
       soil contaminated by cat feces or by ingestion of tissue cysts present
       in undercooked red meats. In patients with AIDS, TE probably results
       from the reactivation of Toxoplasma tissue cysts that remained latent
       after the primary infection. Detection of IgG antibodies to Toxoplasma
       indicates prior infection and the possible presence of tissue cysts and,
       thus, risk for developing TE. A regimen of trimethoprim-sulfamethoxazole
       or dapsone plus pyrimethamine with leucovorin is recommended for persons
       infected with the human immunodeficiency virus (HIV) and who are
       seropositive for IgG to Toxoplasma after their CD4+ T lymphocyte counts
       fall to < 100/mm3. HIV-infected persons who are seronegative for IgG to
       Toxoplasma should be counseled to protect themselves from primary
       toxoplasmic infection by eating only well-cooked meats and washing their
       hands after outdoor activities involving soil contact; if they have a
       cat, they should feed it only commercial or well-cooked foods, keep it
       indoors, and make sure that the litter box is changed daily.
       HIV-infected persons who are Toxoplasma seropositive may also be advised
       about these preventive behavioral practices.
 DE    Animal  Anti-Infective Agents/THERAPEUTIC USE  AIDS-Related
       Opportunistic Infections/EPIDEMIOLOGY/*PREVENTION &  CONTROL  Cats
       Dapsone/THERAPEUTIC USE  Drug Therapy, Combination
       Encephalitis/EPIDEMIOLOGY/*PREVENTION & CONTROL  Human  Incidence
       Leucovorin/THERAPEUTIC USE  Pyrimethamine/THERAPEUTIC USE  Recurrence
       Risk Factors  Toxoplasmosis, Animal/EPIDEMIOLOGY  Toxoplasmosis,
       Cerebral/EPIDEMIOLOGY/*PREVENTION & CONTROL
       Trimethoprim-Sulfamethoxazole Combination/THERAPEUTIC USE  United
       States/EPIDEMIOLOGY  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

