Data/hora: 06/06/2024 02:37:07

Provedor de dados: | 55
País: | Brazil
Título: | Incidence of congenital toxoplasmosis among infants born to HIV-coinfected mothers: case series and literature review
Autores: | Campos,Flávia Alves; Andrade,Gláucia Manzan Queiroz de; Lanna,Antônio de Pádua Santos; Lage,Bruno Freitas; Assumpção,Maria Vitória Mourão; Pinto,Jorge A.
Data: | 2014-12-01
Ano: | 2014
Palavras-chave: | Congenital toxoplasmosis; HIV; Co-infection.
Resumo: | Introduction:There is a paucity of data on the occurrence of congenital toxoplasmosis in children born to mothers dually infected with HIV and Toxoplasma gondii.Objective:To evaluate aspects of the mother–infant pairs associated with vertical transmission of toxoplasmosis in women co-infected with HIV in a referral center for perinatally acquired infections in Belo Horizonte, Brazil.Methods:Descriptive study of HIV vertically exposed children, with congenital toxoplasmosis, followed at a referral center (cohort/Belo Horizonte). Prenatal and post-natal variables for the mother–infant pairs were evaluated. A literature review with no filtering for time and language was performed to identify reports of congenital toxoplasmosis in HIV vertically exposed children.Results:Among 2007 HIV vertically exposed children evaluated in the period from 1998 to 2011, 10 cases of congenital toxoplasmosis were identified (incidence: 0.5%, 95% confidence interval: 0.24–0.91). In searching the literature 22 additional cases in 17 reports were found. Combining the findings of our cohort with other reported cases, 50% (16/32) of congenital toxoplasmosis in HIV vertically exposed children were from Brazil. The cases of congenital toxoplasmosis in HIV vertically exposed children identified in Brazil occurred mainly in the post-Highly Active Antiretroviral Therapy era (p = 0.002) and presented a lower death rate (p = 0.003) than those from other countries. In the cohort/Belo Horizonte, HIV infection was identified mainly during gestation; T. gondii vertical transmission was observed in pregnant women with CD4+&gt;500 cells/mm3 and latent toxoplasmosis. High rates of ocular lesions (87.5%) and central nervous system involvement (70%) were detected.Conclusions:The risk of vertical transmission of T. gondii in HIV-infected women is low and has been usually associated with maternal immunosuppression and elevated viral load. However, our findings of congenital toxoplasmosis in children born to HIV-infected mothers with latent toxoplasmosis and not immunosuppressed emphasize the need for careful follow-up in these cases.
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702014000600609
Editor: | Brazilian Society of Infectious Diseases
Relação: | 10.1016/j.bjid.2014.05.008
Formato: | text/html
Fonte: | Brazilian Journal of Infectious Diseases  v.18 n.6 2014
Fonte: | info:eu-repo/semantics/openAccess