| Registro completo |
| Provedor de dados: |
BJID
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| País: |
Brazil
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| Título: |
Incidence of congenital toxoplasmosis among infants born to HIV-coinfected mothers: case series and literature review
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| Autores: |
Campos,Flávia Alves
Andrade,Gláucia Manzan Queiroz de
Lanna,Antônio de Pádua Santos
Lage,Bruno Freitas
Assumpção,Maria Vitória Mourão
Pinto,Jorge A.
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| Data: |
2014-12-01
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| Ano: |
2014
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| Palavras-chave: |
Congenital toxoplasmosis
HIV
Co-infection
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| 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+>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.
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| Tipo: |
Info:eu-repo/semantics/article
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| Idioma: |
Inglês
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| Identificador: |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702014000600609
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| Editor: |
Brazilian Society of Infectious Diseases
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| Relação: |
10.1016/j.bjid.2014.05.008
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| Formato: |
text/html
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| Fonte: |
Brazilian Journal of Infectious Diseases v.18 n.6 2014
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| Direitos: |
info:eu-repo/semantics/openAccess
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