Utility of molecular and serodiagnostic tools in cerebral toxoplasmosis with and without tuberculous meningitis in AIDS patients: A study from South India

Utility of molecular and serodiagnostic tools in cerebral toxoplasmosis with and without tuberculous meningitis in AIDS patients: A study from South India

<b>Background:</b> Antemortem diagnosis of cerebral toxoplasmosis, the second most common opportunistic infection (OI) in HIV-infected individuals in developing countries is a challenge. <b>Materials and Methods:</b> <i>Toxoplasma gondii (T.gondii)</i> -specific s...

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Bibliographic Details
Main Authors: Adurthi Sreenivas, Mahadevan Anita, Bantwal Radhika, Satishchandra Parthasarthy, Ramprasad Sujay, Sridhar Hema, Shankar S, Nath Avindra, Jayshree R
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2010-01-01
Series:Annals of Indian Academy of Neurology
Subjects:
B1 gene
cerebral toxoplasmosis
human immunodeficiency virus
<i>T. gondii</i> IgG
<i>Toxoplasma gondii</i>
tuberculous meningitis
Online Access:http://www.annalsofian.org/article.asp?issn=0972-2327;year=2010;volume=13;issue=4;spage=263;epage=270;aulast=Adurthi
Description
Summary:<b>Background:</b> Antemortem diagnosis of cerebral toxoplasmosis, the second most common opportunistic infection (OI) in HIV-infected individuals in developing countries is a challenge. <b>Materials and Methods:</b> <i>Toxoplasma gondii (T.gondii)</i> -specific serology and nested polymerase chain reaction (nPCR) were evaluated in sera and ventricular/lumbar cerebrospinal fluid (CSF) of 22 autopsy confirmed cases of cerebral toxoplasmosis with HIV and 17 controls. Frequency of concomitant <i>T.gondii</i> infection was investigated in 17 cases of HIV-associated tuberculous meningitis (TBM). <b>Results:</b> The sensitivity, specificity, and positive and negative predictive values of <i>T. gondii</i> IgG on CSF (ventricular and lumbar) and sera was 100&#x0025; in histology proven cerebral toxoplasmosis (concentrations: 258 &#177; 50, 231 &#177; 36, and 646 &#177; 243 IU/mL, respectively); majority (94&#x0025;) being high avidity type, suggesting reactivation/reinfection. The sensitivity of B1 nPCR was 100&#x0025; on ventricular CSF, whereas it was only 77&#x0025; on lumbar CSF. Based on histology, nPCR, and IgG serology, <i>T. gondii</i> co-infection with TBM was observed in 65&#x0025; (11/17) of cases. <b>Discussion and Conclusion:</b> CSF IgG serology and nPCR are tests with high sensitivity and specificity for the diagnosis of cerebral toxoplasmosis. TBM and cerebral toxoplasmosis can coexist and should be considered in the background of HIV infection in developing countries.
ISSN:0972-2327
1998-3549

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