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Jaroslav Flegr - One of the best experts on this subject based on the ideXlab platform.
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Physical and Mental Health Status in Toxoplasma-Infected Women before and 3 Years after They Learn about Their Infection: Manipulation or Side-Effects of Impaired Health?
Frontiers Media S.A., 2017Co-Authors: Blanka Šebánková, Jaroslav FlegrAbstract:Latent Toxoplasmosis is known to be associated with specific changes in animal and human behavior and human personality. Many Toxoplasmosis-associated shifts, such as an extroversion-introversion shift or a trust-suspicion shift, go in opposite directions in men and women. The stress coping hypothesis suggests that such behavioral effects of Toxoplasmosis are side effects of chronic stress caused by lifelong parasitosis and associated health disorders. Several studies have searched for, and typically found, indices of impaired health in infected subjects. However, subjects were always aware of their Toxoplasmosis status, which could influence obtained data and cause false-positive results of the studies. Here we searched for differences in physical and mental health status among 39 Toxoplasma-infected and 40 Toxoplasma-free female university students who completed identical questionnaires (N-70, and anamnestic questionnaire), before and 3 years after they were informed of their Toxoplasmosis status. Our results showed that infected women showed indices of poorer health status, not only after, but also before they were informed of their infection. In accordance with previously published data, these indices were more numerous and stronger in Rh-negative than in Rh-positive women. Present results suggest that observed indices of poorer health and symptoms of chronic stress in Toxoplasma-infected subjects are real. Due to its high (30%) prevalence, Toxoplasmosis could represent an important factor for public health
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Toxoplasma-infected subjects report an Obsessive-Compulsive Disorder diagnosis more often and score higher in Obsessive-Compulsive Inventory.
European psychiatry : the journal of the Association of European Psychiatrists, 2016Co-Authors: Jaroslav Flegr, Jiri HoracekAbstract:Abstract Background Latent Toxoplasmosis, the life-long presence of dormant stages of Toxoplasma in immunoprivileged organs and of anamnestic IgG antibodies in blood, affects about 30% of humans. Infected subjects have an increased incidence of various disorders, including schizophrenia. Several studies, as well as the character of Toxoplasmosis-associated disturbance of neurotransmitters, suggest that Toxoplasmosis could also play an etiological role in Obsessive-Compulsive Disorder (OCD). Methods The aim of the present cross-sectional study performed on a population of 7471 volunteers was to confirm the association between Toxoplasmosis and OCD, and Toxoplasmosis and psychological symptoms of OCD estimated by the standard Obsessive-Compulsive Inventory-Revised (OCI-R). Results Incidence of OCD was 2.18% ( n =39) in men and 2.28% ( n =83) in women. Subjects with Toxoplasmosis had about a 2.5 times higher odds of OCD and about a 2.7 times higher odds of learning disabilities. The incidence of 18 other neuropsychiatric disorders did not differ between Toxoplasma -infected and Toxoplasma -free subjects. The infected subjects, even the OCD-free subjects, scored higher on the OCI-R. Limitations: Examined subjects provided the information about their Toxoplasmosis and OCD statuses themselves, which could result in underrating the strength of observed associations. Conclusions The results confirmed earlier reports of the association between Toxoplasmosis and OCD. They also support recent claims that latent Toxoplasmosis is in fact a serious disease with many impacts on quality of life of patients.
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Effects of Latent Toxoplasmosis on Autoimmune Thyroid Diseases in Pregnancy
2016Co-Authors: Jaroslav Flegr, Pavel CaldaAbstract:Background: Toxoplasmosis, one of the most common zoonotic diseases worldwide, can induce various hormonal and behavioural alterations in infected hosts, and its most common form, latent Toxoplasmosis, influences the course of pregnancy. Autoimmune thyroid diseases (AITD) belong to the well-defined risk factors for adverse pregnancy outcomes. The aim of this study was to investigate whether there is a link between latent Toxoplasmosis and maternal AITD in pregnancy. Methods: Cross-sectional study in 1248 consecutive pregnant women in the 9–12th gestational weeks. Serum thyroid-stimulating hormone (TSH), thyroperoxidase antibodies (TPOAb), and free thyroxine (FT4) were assessed by chemiluminescence; the Toxoplasma status was detected by the complement fixation test (CFT) and anti-Toxoplasma IgG enzyme-linked immunosorbent assay (ELISA). Results: Overall, 22.5 % of the women were positive for latent Toxoplasmosis and 14.7 % were screened positive for AITD. Women with latent Toxoplasmosis had more often highly elevated TPOAb than the Toxoplasma-negative ones (p = 0.004), and latent Toxoplasmosis was associated with decrease in serum TSH levels (p = 0.049). Moreover, we found a positive correlation between FT4 and the index of positivity for anti-Toxoplasma IgG antibodies (p = 0.033), which was even stronger in the TPOAb-positive Toxoplasma-positive women, (p = 0.014), as well as a positive correlation between FT4 and log2 CF
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Toxoplasmosis a global threat correlation of latent Toxoplasmosis with specific disease burden in a set of 88 countries
PLOS ONE, 2014Co-Authors: Jaroslav Flegr, Joseph Prandota, Michaela Sovickova, Zafar H IsrailiAbstract:Background: Toxoplasmosis is becoming a global health hazard as it infects 30–50% of the world human population. Clinically, the life-long presence of the parasite in tissues of a majority of infected individuals is usually considered asymptomatic. However, a number of studies show that this ‘asymptomatic infection’ may also lead to development of other human pathologies. Aims of the Study: The purpose of the study was to collect available geoepidemiological data on seroprevalence of Toxoplasmosis and search for its relationship with mortality and disability rates in different countries. Methods and Findings: Prevalence data published between 1995–2008 for women in child-bearing age were collected for 88 countries (29 European). The association between prevalence of Toxoplasmosis and specific disease burden estimated with age-standardized Disability Adjusted Life Year (DALY) or with mortality, was calculated using General Linear Method with Gross Domestic Product per capita (GDP), geolatitude and humidity as covariates, and also using nonparametric partial Kendall correlation test with GDP as a covariate. The prevalence of Toxoplasmosis correlated with specific disease burden in particular countries explaining 23% of variability in disease burden in Europe. The analyses revealed that for example, DALY of 23 of 128 analyzed diseases and disease categories on the WHO list showed correlations (18 positive, 5 negative) with prevalence of Toxoplasmosis and another 12 diseases showed positive trends (p,0.1). For several obtained significant correlations between the seroprevalence of Toxoplasmosis and specific diseases/clinical entities, possible pathophysiological, biochemical and molecular explanations are presented. Conclusions: The seroprevalence of Toxoplasmosis correlated with various disease burden. Statistical associations does not necessarily mean causality. The precautionary principle suggests however that possible role of Toxoplasmosis as a triggering factor responsible for development of several clinical entities deserves much more attention and financial support both in everyday medical practice and future clinical research.
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Fatal Attraction Phenomenon in Humans – Cat Odour Attractiveness Increased for Toxoplasma-Infected Men While Decreased for Infected Women
2013Co-Authors: Jaroslav Flegr, Pavlina Lenochova, Zdeněk Hodný, Marta VondrováAbstract:Background: Latent Toxoplasmosis, a lifelong infection with the protozoan Toxoplasma gondii, has cumulative effects on the behaviour of hosts, including humans. The most impressive effect of Toxoplasmosis is the ‘‘fatal attraction phenomenon,’’ the conversion of innate fear of cat odour into attraction to cat odour in infected rodents. While most behavioural effects of Toxoplasmosis were confirmed also in humans, neither the fatal attraction phenomenon nor any Toxoplasmosis-associated changes in olfactory functions have been searched for in them. Principal Findings: Thirty-four Toxoplasma-infected and 134 noninfected students rated the odour of urine samples from cat, horse, tiger, brown hyena and dog for intensity and pleasantness. The raters were blind to their infection status and identity of the samples. No signs of changed sensitivity of olfaction were observed. However, we found a strong, gender dependent effect of Toxoplasmosis on the pleasantness attributed to cat urine odour (p = 0.0025). Infected men rated this odour as more pleasant than did the noninfected men, while infected women rated the same odour as less pleasant than did noninfected women. Toxoplasmosis did not affect how subjects rated the pleasantness of any other animal species’ urine odour; however, a non-significant trend in the same directions was observed for hyena urine. Conclusions: The absence of the effects of Toxoplasmosis on the odour pleasantness score attributed to large cats would suggest that the amino acid felinine could be responsible for the fatal attraction phenomenon. Our results also raise th
Aniki Rothova - One of the best experts on this subject based on the ideXlab platform.
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reactivations of ocular Toxoplasmosis after cataract extraction
Ophthalmology, 2002Co-Authors: Lotje H Boschdriessen, J. S. Stilma, Marjolijn B Plaisier, Allegonda Van Der Lelij, Aniki RothovaAbstract:Abstract Purpose To determine the risk of reactivation of ocular Toxoplasmosis following cataract extraction. Design Retrospective case-control study. Participants Out of 154 patients with ocular Toxoplasmosis, 14 patients (15 eyes) who had undergone a cataract extraction and 45 age- and sex- matched controls without cataract were selected. Intervention A review of the medical records of 14 patients with ocular Toxoplasmosis and cataract and 45 control patients with ocular Toxoplasmosis but without cataract. The clinical records of the controls and patients were assessed for an identical 4-month period following the date of the cataract extraction in the index patients. Main outcome measures Development of a new active retinal lesion within 4 months after cataract surgery in patients and age -and sex matched-controls. The presence of risk factors such as sex, congenital or postnatal acquisition of ocular Toxoplasmosis, age at first clinical manifestation of ocular Toxoplasmosis, total number of attacks per affected eye, type of cataract, age at the time of cataract surgery and the intervals between surgery and first clinical manifestation of ocular Toxoplasmosis and between surgery and the last recurrence of ocular Toxoplasmosis, as well as the use of antiparasitic medication during surgery, type and complications of surgery and optimal visual acuity before and after cataract surgery. Results Reactivations of ocular Toxoplasmosis following cataract extraction occurred in 5/14 patients (5/15 eyes), which was higher than the incidence of recurrences in age -and sex-matched controls ( p No additional risk factors for the development of recurrences of ocular Toxoplasmosis after cataract surgery were found. Incidence of recurrences preceding surgery did not differ between patients and controls. Conclusion We identified an increased risk of reactivation of ocular Toxoplasmosis following cataract extraction which implies that prophylactic treatment with antiparasitic drugs during and after the cataract surgery might be worthwhile for patients at risk of visual loss.
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Retinal detachment in ocular Toxoplasmosis.
Ophthalmology, 2000Co-Authors: Lotje H. Bosch-driessen, Shakila Karimi, J. S. Stilma, Aniki RothovaAbstract:Abstract Purpose To report on the clinical course and prognosis of retinal breaks and detachment occurring in patients with ocular Toxoplasmosis. Design Retrospective cross-sectional observational study. Participants One hundred fifty consecutive patients with ocular Toxoplasmosis. Intervention A review of all records of patients with ocular Toxoplasmosis who had consulted our department from 1990 through 1997 was performed. Main outcome measures The presence of retinal detachment or breaks and possible risk factors, such as age, myopia, the interval between the last recurrence of inflammation and the onset of retinal detachment, severity of vitritis, previous treatment methods, and the location of the retinal abnormalities, were analyzed. Results We found a frequency of 6% (9/150) for retinal detachment and an additional 5% (7/150) for retinal breaks among our patients with ocular Toxoplasmosis. Attacks of active ocular Toxoplasmosis preceding the retinal detachment or retinal breaks were characterized by severe intraocular inflammation. The frequency of myopia in our patients with retinal detachment or retinal breaks was significantly higher than in patients with ocular Toxoplasmosis without retinal detachment or retinal breaks. The functional prognosis for the patients with retinal detachment was poor; legal blindness (visual acuity ≤ 20/200) resulting from retinal detachment occurred in five of the nine patients. Conclusions Careful retinal examination in ocular Toxoplasmosis is warranted, especially in patients with myopia and severe intraocular inflammation.
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serologic evaluation of patients with primary and recurrent ocular Toxoplasmosis for evidence of recent infection
American Journal of Ophthalmology, 1999Co-Authors: Jenny V Ongkosuwito, Aize Kijlstra, E H Boschdriessen, Aniki RothovaAbstract:PURPOSE: To identify the frequency of recently acquired vs chronic systemic Toxoplasma gondii infections in patients with ocular Toxoplasmosis. METHODS: Serum samples from 22 patients with primary ocular Toxoplasmosis (not from scars) and 42 patients with recurrent ocular Toxoplasmosis were tested for the presence of anti–T. gondii IgM, IgG, and IgA antibodies and compared with samples from 24 patients with other causes of uveitis. Intraocular production of anti–T. gondii IgG and IgA, and the presence of T. gondii DNA was determined in patients and control subjects from whom ocular fluid was available. RESULTS: Serologic evidence of recently acquired infection was found for 11 (50%) of 22 patients with primary ocular Toxoplasmosis and for one (2%) of 42 with recurrent ocular Toxoplasmosis. In the uveitis control group, anti–T. gondii IgM antibodies could be detected in two (8%) of 24 patients, but anti–T. gondii IgA antibodies were not detectable. Patients with primary ocular Toxoplasmosis and serologic markers of recently acquired systemic infection were significantly older than those with chronic infection (P = .008). Intraocular production of anti–T. gondii IgG was more frequently noted in patients with recurrent than primary ocular Toxoplasmosis (81% vs 41%; P < .001), but intraocular T. gondii DNA was more frequently found in patients with primary ocular Toxoplasmosis than in those with recurrent ocular Toxoplasmosis (37% vs 4%; P < .01). CONCLUSIONS: Primary ocular Toxoplasmosis can be seen in either recently acquired or chronic T. gondii infection. Patients with ocular disease and recently acquired infection were older and more likely to have T. gondii DNA in intraocular fluids.
Marta Vondrová - One of the best experts on this subject based on the ideXlab platform.
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Fatal Attraction Phenomenon in Humans – Cat Odour Attractiveness Increased for Toxoplasma-Infected Men While Decreased for Infected Women
2013Co-Authors: Jaroslav Flegr, Pavlina Lenochova, Zdeněk Hodný, Marta VondrováAbstract:Background: Latent Toxoplasmosis, a lifelong infection with the protozoan Toxoplasma gondii, has cumulative effects on the behaviour of hosts, including humans. The most impressive effect of Toxoplasmosis is the ‘‘fatal attraction phenomenon,’’ the conversion of innate fear of cat odour into attraction to cat odour in infected rodents. While most behavioural effects of Toxoplasmosis were confirmed also in humans, neither the fatal attraction phenomenon nor any Toxoplasmosis-associated changes in olfactory functions have been searched for in them. Principal Findings: Thirty-four Toxoplasma-infected and 134 noninfected students rated the odour of urine samples from cat, horse, tiger, brown hyena and dog for intensity and pleasantness. The raters were blind to their infection status and identity of the samples. No signs of changed sensitivity of olfaction were observed. However, we found a strong, gender dependent effect of Toxoplasmosis on the pleasantness attributed to cat urine odour (p = 0.0025). Infected men rated this odour as more pleasant than did the noninfected men, while infected women rated the same odour as less pleasant than did noninfected women. Toxoplasmosis did not affect how subjects rated the pleasantness of any other animal species’ urine odour; however, a non-significant trend in the same directions was observed for hyena urine. Conclusions: The absence of the effects of Toxoplasmosis on the odour pleasantness score attributed to large cats would suggest that the amino acid felinine could be responsible for the fatal attraction phenomenon. Our results also raise th
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Fatal attraction phenomenon in humans: cat odour attractiveness increased for toxoplasma-infected men while decreased for infected women.
PLoS neglected tropical diseases, 2011Co-Authors: Jaroslav Flegr, Pavlina Lenochova, Zdeněk Hodný, Marta VondrováAbstract:Background: Latent Toxoplasmosis, a lifelong infection with the protozoan Toxoplasma gondii, has cumulative effects on the behaviour of hosts, including humans. The most impressive effect of Toxoplasmosis is the ‘‘fatal attraction phenomenon,’’ the conversion of innate fear of cat odour into attraction to cat odour in infected rodents. While most behavioural effects of Toxoplasmosis were confirmed also in humans, neither the fatal attraction phenomenon nor any Toxoplasmosis-associated changes in olfactory functions have been searched for in them. Principal Findings: Thirty-four Toxoplasma-infected and 134 noninfected students rated the odour of urine samples from cat, horse, tiger, brown hyena and dog for intensity and pleasantness. The raters were blind to their infection status and identity of the samples. No signs of changed sensitivity of olfaction were observed. However, we found a strong, gender dependent effect of Toxoplasmosis on the pleasantness attributed to cat urine odour (p=0.0025). Infected men rated this odour as more pleasant than did the noninfected men, while infected women rated the same odour as less pleasant than did noninfected women. Toxoplasmosis did not affect how subjects rated the pleasantness of any other animal species’ urine odour; however, a non-significant trend in the same directions was observed for hyena urine. Conclusions: The absence of the effects of Toxoplasmosis on the odour pleasantness score attributed to large cats would suggest that the amino acid felinine could be responsible for the fatal attraction phenomenon. Our results also raise the possibility that the odour-specific threshold deficits observed in schizophrenia patients could be caused by increased prevalence of Toxoplasma-infected subjects in this population rather than by schizophrenia itself. The trend observed with the hyena urine sample suggests that this carnivore, and other representatives of the Feliformia suborder, should be studied for their possible role as definitive hosts in the life cycle of Toxoplasma.
Rima Mcleod - One of the best experts on this subject based on the ideXlab platform.
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severe congenital Toxoplasmosis in the united states clinical and serologic findings in untreated infants
Pediatric Infectious Disease Journal, 2011Co-Authors: Tudor Olariu, Jack S Remington, Rima Mcleod, Ambereen Alam, Jose G. MontoyaAbstract:Background Congenital Toxoplasmosis can cause significant neurologic manifestations and other untoward sequelae. Methods The Palo Alto Medical Foundation Toxoplasma Serology Laboratory database was searched for data on infants 0 to 180 days old, in whom congenital Toxoplasmosis had been confirmed and who had been tested for Toxoplasma gondii-specific immunoglobulin G (IgG), IgM, and IgA antibodies, between 1991 and 2005. Their clinical findings were confirmed at the National Collaborative Chicago-based Congenital Toxoplasmosis Study center. We reviewed available clinical data and laboratory profiles of 164 infants with congenital Toxoplasmosis whose mothers had not been treated for the parasite during gestation. Results One or more severe clinical manifestations of congenital Toxoplasmosis were reported in 84% of the infants and included eye disease (92.2%), brain calcifications (79.6%), and hydrocephalus (67.7%). In 61.6% of the infants, eye disease, brain calcifications, and hydrocephalus were present concurrently. T. gondii-specific IgM, IgA, and IgE antibodies were demonstrable in 86.6%, 77.4%, and 40.2% of the infants, respectively. Testing for IgM and IgA antibodies increased the sensitivity of making the diagnosis of congenital Toxoplasmosis to 93% compared with testing for IgM or IgA individually. IgM and IgA antibodies were still present in 43.9% of infants diagnosed between 1 and 6 months of life. Conclusions Our study reveals that severe clinical signs of congenital Toxoplasmosis including hydrocephalus, eye disease, or intracranial calcifications occurred in 85% infants whose sera were referred to our reference Toxoplasma Serology Laboratory during a period of 15 years. Laboratory tests, including serologic and polymerase chain reaction tests, were critical for diagnosis in the infants. Our results contrast remarkably with those of European investigators who rarely observe severe clinical signs in infants with congenital Toxoplasmosis.
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Why prevent, diagnose and treat congenital Toxoplasmosis?
Memorias do Instituto Oswaldo Cruz, 2009Co-Authors: Rima Mcleod, Francois Kieffer, Mari Sautter, Tiffany Hosten, Herve PellouxAbstract:Evidence that prevention, diagnosis and treatment of Toxoplasmosis is beneficial developed as follows: anti-parasitic agents abrogate Toxoplasma gondii tachyzoite growth, preventing destruction of infected, cultured, mammalian cells and cure active infections in experimental animals, including primates. They treat active infections in persons who are immune-compromised, limit destruction of retina by replicating parasites and thereby treat ocular Toxoplasmosis and treat active infection in the fetus and infant. Outcomes of untreated congenital Toxoplasmosis include adverse ocular and neurologic sequelae described in different countries and decades. Better outcomes are associated with treatment of infected infants throughout their first year of life. Shorter intervals between diagnosis and treatment in utero improve outcomes. A French approach for diagnosis and treatment of congenital Toxoplasmosis in the fetus and infant can prevent Toxoplasmosis and limit adverse sequelae. In addition, new data demonstrate that this French approach results in favorable outcomes with some early gestation infections. A standardized approach to diagnosis and treatment during gestation has not yet been applied generally in the USA. Nonetheless, a small, similar experience confirms that this French approach is feasible, safe, and results in favorable outcomes in the National Collaborative Chicago-based Congenital Toxoplasmosis Study cohort. Prompt diagnosis, prevention and treatment reduce adverse sequelae of congenital Toxoplasmosis.
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risk factors for toxoplasma gondii infection in mothers of infants with congenital Toxoplasmosis implications for prenatal management and screening
American Journal of Obstetrics and Gynecology, 2005Co-Authors: Charles N. Swisher, Shawn Withers, Kenneth M Boyer, Nancy Roizen, Jack S Remington, Ellen Holfels, Douglas G Mack, Paul Meier, Rima McleodAbstract:Objective The purpose of this study was to determine whether demographic characteristics, history of exposure to recognized transmission vehicles, or illness that was compatible with acute Toxoplasmosis during gestation identified most mothers of infants with congenital Toxoplasmosis. Study design Mothers of 131 infants and children who were referred to a national study of treatment for congenital Toxoplasmosis were characterized demographically and questioned concerning exposure to recognized risk factors or illness. Results No broad demographic features identified populations that were at risk. Only 48% of mothers recognized epidemiologic risk factors (direct or indirect exposure to raw/undercooked meat or to cat excrement) or gestational illnesses that were compatible with acute acquired Toxoplasmosis during pregnancy. Conclusion Maternal risk factors or compatible illnesses were recognized in retrospect by fewer than one half of North American mothers of infants with Toxoplasmosis. Educational programs might have prevented acquisition of Toxoplasma gondii by those mothers who had clear exposure risks. However, only systematic serologic screening of all pregnant women at prenatal visits or of all newborn infants at birth would prevent or detect a higher proportion of these congenital infections.
Vera Lucia Pereirachioccola - One of the best experts on this subject based on the ideXlab platform.
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igg4 specific to toxoplasma gondii excretory secretory antigens in serum and or cerebrospinal fluid support the cerebral Toxoplasmosis diagnosis in hiv infected patients
Journal of Immunological Methods, 2013Co-Authors: Cristina S Meira, José E. Vidal, Thais A Costasilva, Gabriela Motoie, Ricardo Gava, Roberto Mitsuyoshi Hiramoto, Vera Lucia PereirachioccolaAbstract:Abstract Cerebral Toxoplasmosis is the most common neurological opportunistic disease manifested in HIV infected patients. Excretory/secretory antigens (ESA) are serological markers for the diagnosis of reactivation of the infection in HIV-infected patients with cerebral Toxoplasmosis. Immunosuppressed patients develop high antibody titers for ESA. However, little is known about the humoral response for these antigens. The present study analyzed the profile of antibody recognition against ESA in comparison with tachyzoite lysate antigen (TLA) in 265 sera and 270 cerebrospinal fluid (CSF) samples from infected patients with Toxoplasma gondii and or HIV and in sera of 50 healthy individuals. The samples of sera and CSF were organized in 8 groups. The sera sample groups were: Group I — Se/CT/AIDS (patients with cerebral Toxoplasmosis/AIDS) with 58 samples; Group II — Se/ONinf/AIDS/PosT (patients with AIDS/other neuroinfections/positive Toxoplasmosis) with 49 samples; Group III — Se/ONinf/AIDS/NegT (patients with AIDS/other neuroinfections/negative Toxoplasmosis) with 58 samples; Group IV — Se/PosT/NegHIV (individuals with asymptomatic Toxoplasmosis/negative HIV) with 50 samples and Group V — Se/NegT/NegHIV (healthy individuals/negative Toxoplasmosis and HIV) with 50 samples. The CSF sample groups were: Group VI — CSF/CT/AIDS (patients with cerebral Toxoplasmosis/AIDS) with 99 samples; Group VII — CSF/ONinf/AIDS/PosT (patients with AIDS/other neuroinfections/positive Toxoplasmosis) with 112 samples, and Group VIII — CSF/ONinf/AIDS/NegT (patients with AIDS/other neuroinfections/negative Toxoplasmosis) with 59 samples. Levels of IgM, IgA, IgE, IgG and subclasses were determined by ELISA against TLA and ESA antigens. IgM, IgA or IgE antibodies against ESA or TLA were not detected in sera from patients with Toxoplasmosis suggesting that all patients were in chronic phase of the infection. High levels of IgG1 against TLA were found in sera samples from groups I, II and IV and in CSF samples from groups VI and VII; whereas IgG2, IgG3 and IgG4 levels were not detected in the same sera or CSF sample groups. However, patients from groups I and VI, that had tachyzoites circulating in blood and CSF respectively, produced a mix of IgG1 and IgG4 antibodies against ESA. IgG2 against ESA were predominant in serum from patients with the latent (non-active) T. gondii infection/HIV negative and in CSF samples from patients with other neuroinfections and positive Toxoplasmosis (groups IV and VII, respectively). IgG4 levels against ESA were found to be significantly (P
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diagnosis of cerebral Toxoplasmosis in aids patients in brazil importance of molecular and immunological methods using peripheral blood samples
Journal of Clinical Microbiology, 2005Co-Authors: Fabio A Colombo, José E. Vidal, Augusto Cesar Penalva De Oliveira, Roberto Focaccia, Adrian V. Hernandez, Roberta Schiavon Nogueira, Francisco Bonasserfilho, Vera Lucia PereirachioccolaAbstract:Cerebral Toxoplasmosis is the most common cerebral focal lesion in AIDS and still accounts for high morbidity and mortality in Brazil. Its occurrence is more frequent in patients with low CD4(+) T-cell counts. It is directly related to the prevalence of anti-Toxoplasma gondii antibodies in the population. Therefore, it is important to evaluate sensitive, less invasive, and rapid diagnostic tests. We evaluated the value of PCR using peripheral blood samples on the diagnosis of cerebral Toxoplasmosis and whether its association with immunological assays can contribute to a timely diagnosis. We prospectively analyzed blood samples from 192 AIDS patients divided into two groups. The first group was composed of samples from 64 patients with cerebral Toxoplasmosis diagnosed by clinical and radiological features. The second group was composed of samples from 128 patients with other opportunistic diseases. Blood collection from patients with cerebral Toxoplasmosis was done before or on the third day of anti-toxoplasma therapy. PCR for T. gondii, indirect immunofluorescence, enzyme-linked immunosorbent assay, and an avidity test for Toxoplasmosis were performed on all samples. The PCR sensitivity and specificity for diagnosis of cerebral Toxoplasmosis in blood were 80% and 98%, respectively. Patients with cerebral Toxoplasmosis (89%) presented higher titers of anti-T. gondii IgG antibodies than patients with other diseases (57%) (P<0.001). These findings suggest the clinical value of the use of both PCR and high titers of anti-T. gondii IgG antibodies for the diagnosis of cerebral Toxoplasmosis. This strategy may prevent more invasive approaches.
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pcr assay using cerebrospinal fluid for diagnosis of cerebral Toxoplasmosis in brazilian aids patients
Journal of Clinical Microbiology, 2004Co-Authors: José E. Vidal, Fabio A Colombo, Augusto Cesar Penalva De Oliveira, Roberto Focaccia, Vera Lucia PereirachioccolaAbstract:Highly active antiretroviral therapy has decreased the incidence of opportunistic infections in the central nervous system in AIDS patients. However, neurological abnormalities still remain important causes of mortality and morbidity in developing countries. In Brazil, cerebral Toxoplasmosis is the most common cerebral mass lesion in AIDS patients. For these reasons, early, inexpensive, and sensitive diagnostic tests must be evaluated. The aim of this study was to evaluate PCR, using cerebrospinal fluid (CSF) samples to detect Toxoplasma gondii DNA, and to determine if the association of PCR with immunological assays can contribute to a timely diagnosis. We studied two sample groups. First, we analyzed stored CSF samples from 29 newborns and from 39 adults with AIDS without a definitive diagnosis of Toxoplasmosis. The goal of this step was to standardize the methodology with a simple and economical procedure to recover the T. gondii DNA. Next, we prospectively evaluated CSF samples from 12 AIDS patients with a first episode of cerebral Toxoplasmosis and 18 AIDS patients with other neurological opportunistic diseases and without previous cerebral Toxoplasmosis. In all PCR samples, an indirect immunofluorescent assay and an enzyme-linked immunosorbent assay were performed. Samples from all patients with cerebral Toxoplasmosis presented positive PCR results (sensitivity, 100%), and a sample from one of the 18 AIDS patients with other neurological diseases also presented positive PCR results (specificity, 94.4%). These findings suggest the clinical utility of PCR in the diagnosis of cerebral Toxoplasmosis in developing countries.
