Document 0965
 DOCN  M9470965
 TI    Toxoplasma gondii infection in advanced HIV infection.
 DT    9409
 AU    Oksenhendler E; Charreau I; Tournerie C; Azihary M; Carbon C; Aboulker
       JP; INSERM SC10, Villejuif, France.
 SO    AIDS. 1994 Apr;8(4):483-7. Unique Identifier : AIDSLINE MED/94280720
 AB    OBJECTIVE: To study Toxoplasma encephalitis (TE) in advanced HIV
       infection, including predictive factors, possible prophylactic regimens
       and impact on survival. DESIGN: Epidemiological analysis of data
       collected prospectively during the Alpha study, a double-blind,
       randomized clinical trial, comparing two doses of dideoxyinosine in
       patients with advanced HIV disease. PATIENTS: First episode of TE
       occurred in 75 out of 499 patients participating in the trial. METHODS:
       Kaplan-Meier estimates and semi-parametric Cox's model were used.
       RESULTS: A low CD4 cell count and a positive Toxoplasma serology were
       strongly predictive of the occurrence of TE. In patients with CD4 counts
       < 100 x 10(6)/l and a positive Toxoplasma serology at entry to the
       study, the 12-month TE incidence was 25.4%. Patients who were receiving
       at entry any of the following potentially antitoxoplasmic drugs:
       trimethoprim-sulphamethoxazole, pyrimethamine, dapsone,
       pyrimethamine-sulphadoxine or sulphadiazine, had a lower TE incidence
       than those who were not; 6.2 versus 18.8%, respectively (P < 0.001). The
       rate of survival 12 months after TE was 29.6%. Even after adjusting the
       major prognostic covariates, TE was predictive of death (P < 0.001;
       relative risk, 1.8). CONCLUSIONS: The high HIV incidence, morbidity and
       mortality in high-prevalence areas suggests that primary prophylaxis
       should be given in patients at high risk for toxoplasmic reactivation.
 DE    Adult  AIDS-Related Opportunistic Infections/*EPIDEMIOLOGY/MORTALITY/
       PREVENTION & CONTROL  Dapsone/THERAPEUTIC USE
       Encephalitis/EPIDEMIOLOGY/MORTALITY/PREVENTION & CONTROL  Female  Human
       Male  Middle Age  Pyrimethamine/THERAPEUTIC USE
       Sulfadiazine/THERAPEUTIC USE  Sulfadoxine/THERAPEUTIC USE  Survival Rate
       Toxoplasmosis/*EPIDEMIOLOGY/MORTALITY/PREVENTION & CONTROL
       Toxoplasmosis, Cerebral/*EPIDEMIOLOGY/MORTALITY/PREVENTION &  CONTROL
       Trimethoprim-Sulfamethoxazole Combination/THERAPEUTIC USE  JOURNAL
       ARTICLE  MULTICENTER STUDY

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