Incidence of congenital toxoplasmosis among infants born to HIV-coinfected mothers: case series and literature review
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 wit...
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| Format: | Article |
| Language: | English |
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Elsevier
2014-11-01
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| Series: | Brazilian Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867014001287 |
| _version_ | 1819104203714330624 |
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| author | Flávia Alves Campos Gláucia Manzan Queiroz de Andrade Antônio de Pádua Santos Lanna Bruno Freitas Lage Maria Vitória Mourão Assumpção Jorge A. Pinto |
| author_facet | Flávia Alves Campos Gláucia Manzan Queiroz de Andrade Antônio de Pádua Santos Lanna Bruno Freitas Lage Maria Vitória Mourão Assumpção Jorge A. Pinto |
| author_sort | Flávia Alves Campos |
| collection | DOAJ |
| description | 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. Keywords: Congenital toxoplasmosis, HIV, Co-infection |
| first_indexed | 2024-12-22T02:02:37Z |
| format | Article |
| id | doaj.art-df0151f744e14b95af3d8d9c391b9d73 |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-22T02:02:37Z |
| publishDate | 2014-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-df0151f744e14b95af3d8d9c391b9d732022-12-21T18:42:37ZengElsevierBrazilian Journal of Infectious Diseases1413-86702014-11-01186609617S1413-86702014000600609Incidence of congenital toxoplasmosis among infants born to HIV-coinfected mothers: case series and literature reviewFlávia Alves Campos0Gláucia Manzan Queiroz de Andrade1Antônio de Pádua Santos Lanna2Bruno Freitas Lage3Maria Vitória Mourão Assumpção4Jorge A. Pinto5Program in Child and Adolescent Health, Universidade Federal de Minas Gerais (UFMG), Pediatrician, Children's Hospital João Paulo II, FHEMIG, Belo Horizonte, MG, Brazil; Corresponding author at: Universidade Federal de Minas Gerais, Departamento de Pediatria, Av. Alfredo Balena, 190, B. Santa Efigênia, 30130-100 Belo Horizonte, MG, Brazil.Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, BrazilSchool of Medicine, Federal University of Minas Gerais, MG, BrazilSchool of Medicine, Federal University of Minas Gerais, MG, BrazilChildren's Hospital João Paulo II, FHEMIG, MG, BrazilDepartment of Pediatrics, Pediatric Immunology Division, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, BrazilIntroduction: 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. Keywords: Congenital toxoplasmosis, HIV, Co-infectionhttp://www.sciencedirect.com/science/article/pii/S1413867014001287 |
| spellingShingle | Flávia Alves Campos Gláucia Manzan Queiroz de Andrade Antônio de Pádua Santos Lanna Bruno Freitas Lage Maria Vitória Mourão Assumpção Jorge A. Pinto Incidence of congenital toxoplasmosis among infants born to HIV-coinfected mothers: case series and literature review Brazilian Journal of Infectious Diseases |
| title | Incidence of congenital toxoplasmosis among infants born to HIV-coinfected mothers: case series and literature review |
| title_full | Incidence of congenital toxoplasmosis among infants born to HIV-coinfected mothers: case series and literature review |
| title_fullStr | Incidence of congenital toxoplasmosis among infants born to HIV-coinfected mothers: case series and literature review |
| title_full_unstemmed | Incidence of congenital toxoplasmosis among infants born to HIV-coinfected mothers: case series and literature review |
| title_short | Incidence of congenital toxoplasmosis among infants born to HIV-coinfected mothers: case series and literature review |
| title_sort | incidence of congenital toxoplasmosis among infants born to hiv coinfected mothers case series and literature review |
| url | http://www.sciencedirect.com/science/article/pii/S1413867014001287 |
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