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A preliminary study of the frequency of focal neurological deficits in HIV/AIDS patients seropositive for Toxoplasma gondii IgG in Lagos, Nigeria.
Nig Q J Hosp Med 2010 Jul-Sep; 20(3):104-7NQ

Abstract

BACKGROUND

Cerebral toxoplasmosis is a common cause of focal neurologic deficits in HIV/AIDS. Financial constraints and access to neuroradiological facilities limit definitive diagnosis and first-line treatments are largely expensive and cumbersome.

OBJECTIVE

This study examined the frequency of focal neurological signs in HIV/AIDS patients with positive Toxoplasma gondii IgG antibodies (and thus at high risk of reactivation), and the relationship to CD4 count.

METHODS

Using a case-control design, T. gondii IgG serology was determined in 83 HIV/AIDS patients on HAART and 42 HIV seronegative controls. Neurological evaluation and CD4 count (mm3) was conducted in all subjects.

RESULTS

A total of 71 (85.5%) HIV/AIDS patients were seropositive for T. gondii IgG. The IgG seroprevalence was 84.8% for cases with CD4 count < 200 and 86.0% with CD4 < or = 200 (P = 0.46). Of the cases with positive Toxoplasma antibodies, the frequency of neurological lateralizing signs was higher in those with CD4 count < 200 (32.6%) compared to persons with CD4 count > or = 200 (7.1%) (chi2 = 4.90, Fisher exact P <0.01). The mean CD4 count of cases with lateralizing signs was 113.7 +/- 113.9 in contrast to 254.0 +/- 218.9 in those without lateralizing signs (P < 0.01).

CONCLUSION

In our study, a higher frequency of focal neurological signs was found in the T. gondii seropositive HIV/AIDS patients with a higher degree of immune compromise (CD4 count < 200). We suggest the adoption of routine prophylactic anti-toxoplasma therapy in this subgroup given that cerebral toxoplasmosis is a leading cause of intracranial space occupying lesions in HIV/AIDS.

Authors+Show Affiliations

Neurology Unit, Department of Medicine, College of Medicine, University of Lagos & Lagos University Teaching Hospital (LUTH), Idi Araba, Nigeria.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21033315

Citation

Oshinaike, O O., et al. "A Preliminary Study of the Frequency of Focal Neurological Deficits in HIV/AIDS Patients Seropositive for Toxoplasma Gondii IgG in Lagos, Nigeria." Nigerian Quarterly Journal of Hospital Medicine, vol. 20, no. 3, 2010, pp. 104-7.
Oshinaike OO, Okubadejo NU, Ojini FI, et al. A preliminary study of the frequency of focal neurological deficits in HIV/AIDS patients seropositive for Toxoplasma gondii IgG in Lagos, Nigeria. Nig Q J Hosp Med. 2010;20(3):104-7.
Oshinaike, O. O., Okubadejo, N. U., Ojini, F. I., & Danesi, M. A. (2010). A preliminary study of the frequency of focal neurological deficits in HIV/AIDS patients seropositive for Toxoplasma gondii IgG in Lagos, Nigeria. Nigerian Quarterly Journal of Hospital Medicine, 20(3), pp. 104-7.
Oshinaike OO, et al. A Preliminary Study of the Frequency of Focal Neurological Deficits in HIV/AIDS Patients Seropositive for Toxoplasma Gondii IgG in Lagos, Nigeria. Nig Q J Hosp Med. 2010;20(3):104-7. PubMed PMID: 21033315.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A preliminary study of the frequency of focal neurological deficits in HIV/AIDS patients seropositive for Toxoplasma gondii IgG in Lagos, Nigeria. AU - Oshinaike,O O, AU - Okubadejo,N U, AU - Ojini,F I, AU - Danesi,M A, PY - 2010/11/2/entrez PY - 2010/11/3/pubmed PY - 2010/11/10/medline SP - 104 EP - 7 JF - Nigerian quarterly journal of hospital medicine JO - Nig Q J Hosp Med VL - 20 IS - 3 N2 - BACKGROUND: Cerebral toxoplasmosis is a common cause of focal neurologic deficits in HIV/AIDS. Financial constraints and access to neuroradiological facilities limit definitive diagnosis and first-line treatments are largely expensive and cumbersome. OBJECTIVE: This study examined the frequency of focal neurological signs in HIV/AIDS patients with positive Toxoplasma gondii IgG antibodies (and thus at high risk of reactivation), and the relationship to CD4 count. METHODS: Using a case-control design, T. gondii IgG serology was determined in 83 HIV/AIDS patients on HAART and 42 HIV seronegative controls. Neurological evaluation and CD4 count (mm3) was conducted in all subjects. RESULTS: A total of 71 (85.5%) HIV/AIDS patients were seropositive for T. gondii IgG. The IgG seroprevalence was 84.8% for cases with CD4 count < 200 and 86.0% with CD4 < or = 200 (P = 0.46). Of the cases with positive Toxoplasma antibodies, the frequency of neurological lateralizing signs was higher in those with CD4 count < 200 (32.6%) compared to persons with CD4 count > or = 200 (7.1%) (chi2 = 4.90, Fisher exact P <0.01). The mean CD4 count of cases with lateralizing signs was 113.7 +/- 113.9 in contrast to 254.0 +/- 218.9 in those without lateralizing signs (P < 0.01). CONCLUSION: In our study, a higher frequency of focal neurological signs was found in the T. gondii seropositive HIV/AIDS patients with a higher degree of immune compromise (CD4 count < 200). We suggest the adoption of routine prophylactic anti-toxoplasma therapy in this subgroup given that cerebral toxoplasmosis is a leading cause of intracranial space occupying lesions in HIV/AIDS. SN - 0189-2657 UR - https://www.unboundmedicine.com/medline/citation/21033315/A_preliminary_study_of_the_frequency_of_focal_neurological_deficits_in_HIV/AIDS_patients_seropositive_for_Toxoplasma_gondii_IgG_in_Lagos_Nigeria_ L2 - http://www.diseaseinfosearch.org/result/279 DB - PRIME DP - Unbound Medicine ER -