Resumen

CASANOVA SOTOLONGO, Pedro; CASANOVA CARRILLO, Pedro  y  CASANOVA CARRILLO, Carlos. Toxoplasmosis cerebral durante la infección por el virus de inmunodeficiencia humana. Rev cubana med [online]. 2002, vol.41, n.5, pp.297-302. ISSN 0034-7523.

It is stressed that about one third of the patients with HIV infections have nervous complications that cause considerable morbidity and mortality and that the main neurological manifestations depend on the primary infection due to this virus, to secondary opportunistic infections or to complications of the antiretroviral therapy. Any site of the nervous system, be central, peripheral or muscular may be affected during HIV infection. Generally, toxoplasmic encephalitis results from the reactivation of an endogenous infection. Felines, specially cats, are definitive hosts; the human beign is an accidental host capable of controlling the infection under normal immunity conditions. The toxoplasm infects all the central nervous system difussely from the initial stages. Neurotoxoplasmosis together with encephalopathy are some of the most common forms of brain compromise, mainly with clinic of focal dysfunction in HIV-infected patients. The prognosis and survival of these patients depend on the diagnosis and on a timely and efficient treatment. The presumptive diagnosis of toxoplasmic encephalitis is based on the triad of positive toxoplasma serology, characteristic radiography and good response to antitoxoplasmic empiric treatment. Although rarely necessary, the definitive diagnosis is based on the proved presence of TG in the biopsy specimen or in the injury aspirate. In the acute infection, it is recommended the combined use of pyrimethamine (daraprim), sulfadiazine and folic acid. The use of pyrimethamine at maintenance doses has been proposed for life.

Palabras clave : TOXOPLASMOSIS, CEREBRAL [diagnosis]; ACQUIRED IMMUNODEFICIENCY SYNDROME [complications]; HIV; AIDS-RELATED OPPORTUNISTIC INFECTIONS; PYRIMETHAMINE [therapeutic use]; SULFADIAZINE [therapeutic use]; FOLIC ACID [therapeutic use].