Patients with HIV infection are at risk for infection by Toxoplasma gondii. Specific prophylaxis against toxoplasmosis is indicated when certain risk factors are present.
Study population:
• 1,699 HIV-infected patients in France from 1988 to 1995.
• Infections included both cerebral and extracerebral toxoplasmosis.
Parameter
Relative Risk
95% Confidence Interval
Toxoplasma IgG antibody titer >= 150 IU/mL
3.6
2.1-6.0
CD4+ cell count < 200 per µL
20.8
specific prophylaxis
0.2
0.1-0.3
Testing for Toxoplasma antibodies should be performed every 6 months in patients with advanced immunosupression.
• In the cohort of patients studied, onset of toxoplasmosis was seen 10 days to 74 months after there was a rise in antibody titers.
Prophylaxis should be started in patients with low CD4 cell counts and high Toxoplasma antibody titers.
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