Clinical Presentation and Outcome of Toxoplasma Encephalitis in HIV-Infected Patients from Zaria, Northern Nigeria: A Case Series of 9 Patients

Toxoplasma encephalitis (TE) is the most common cause of focal deficits in patients living with HIV/AIDS. Among 257 HIV-infected adult patients seen between January 2006 and December 2010 in a tertiary hospital in Zaria, northern Nigeria, 9 (3.5%) patients had clinical, serological, and brain imagin...

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Bibliographic Details
Published in:Journal of the International Association of Providers of AIDS Care 2014-01, Vol.13 (1), p.18-21
Main Authors: Ogoina, Dimie, Obiako, Reginald O., Onyemelukwe, Geoffrey C., Musa, Bolanle O., Hamidu, Ahmed Umdagas
Format: Article
Language:English
Subjects:
Adolescent
Adult
AIDS-Related Opportunistic Infections - diagnosis
AIDS-Related Opportunistic Infections - drug therapy
AIDS-Related Opportunistic Infections - microbiology
AIDS-Related Opportunistic Infections - pathology
Encephalitis - diagnosis
Encephalitis - drug therapy
Encephalitis - microbiology
Encephalitis - pathology
Female
HIV Infections - microbiology
Humans
Male
Middle Aged
Nigeria
Seizures - microbiology
Seizures - virology
Toxoplasmosis, Cerebral - diagnosis
Toxoplasmosis, Cerebral - drug therapy
Toxoplasmosis, Cerebral - pathology
Toxoplasmosis, Cerebral - virology
Treatment Outcome
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Summary:Toxoplasma encephalitis (TE) is the most common cause of focal deficits in patients living with HIV/AIDS. Among 257 HIV-infected adult patients seen between January 2006 and December 2010 in a tertiary hospital in Zaria, northern Nigeria, 9 (3.5%) patients had clinical, serological, and brain imaging evidence of TE. All 9 patients had CD4 count of less than 50 cells/mm3. Of the 9 patients, 7 were antiretroviral therapy (ART)-naive, while 2 were cases of ART-induced TE-immune reconstitution inflammatory syndrome. After administering intravenous dexamethasone for cerebral decompression and specific antitoxoplasma therapy, symptoms and signs resolved in 8 patients within 4 to 14 days, but 1 patient died. Our data suggest that even in the ART era in Nigeria, TE remains a fairly common cause of morbidity among HIV-infected patients due to late HIV diagnosis and significant immunosuppression at diagnosis. Early HIV diagnosis, early initiation of highly active ART, and routine prophylaxis against TE are imperative in combating the challenge of HIV/AIDS-related TE in Nigeria.
ISSN:2325-9574
2325-9582
2325-9582
DOI:10.1177/2325957413500529