We report the occurrence of congenital toxoplasmosis in three infants born to HIV infected women who had high anti-toxoplasma IgG and negative IgM during pregnancy. We briefly reviewed available literature and discussed the possible transmission mechanisms of congenital toxoplasmosis among HIV infected pregnant women. Serum samples were tested for Toxoplasma gondii IgM and IgG antibodies using commercial enzyme immunoassay and IgG-avidity tests. In the first case, fetal death occurred at 28th week of gestation. In the second case, congenital toxoplasmosis was diagnosis at 6th month of life; and in the third case, an HIV-infected newborn, congenital toxoplasmosis was asymptomatic. These cases point out to the possibility of enhanced maternal-fetal transmission of T. gondii infection by HIV-infected women chronically infected, which may have important public health consequences, considering that increasing frequency of HIV-infection has been observed among women of childbearing age around the world.
Journal Information
Vol. 14. Issue 2.
Pages 186-189 (March - April 2010)
Vol. 14. Issue 2.
Pages 186-189 (March - April 2010)
Case report
Open Access
Congenital toxoplasmosis transmitted by human immunodeficiency-virus infected women
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Kátia Martins Lopes de Azevedo1,
, Sérgio Setúbal2, Vania Gloria Silami Lopes3, Luiz Antônio Bastos Camacho4, Solange Artimos de Oliveira5
Corresponding author
kmlazevedo@yahoo.com.br
Correspondence to: Disciplina de Doenças Infecciosas e Parasitárias, Hospital Universitário Antônio Pedro Rua Marquês do Paraná, 303, 2° andar Niterói – RJ – Brazil CEP: 24030210. Phone/Fax: +55 21 26299311.
Correspondence to: Disciplina de Doenças Infecciosas e Parasitárias, Hospital Universitário Antônio Pedro Rua Marquês do Paraná, 303, 2° andar Niterói – RJ – Brazil CEP: 24030210. Phone/Fax: +55 21 26299311.
1 MD – Discipline of Infectious and Parasitic Diseases, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil
2 MD, PhD – Discipline of Infectious and Parasitic Diseases, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil
3 MD, PhD – Department of Pathology, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil
4 MD, PhD – Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
5 MD, PhD – Discipline of Infectious and Parasitic Diseases, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil
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Article information
Abstract
Keywords:
congenital toxoplasmosis
human immunodeficiency-virus
prevention
AIDS
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References
[1.]
American College of Obstetricians, Gynecologists.
Perinatal viral and parasitic infections.
ACOG Pract Bull, (2000), pp. 20
[2.]
C. Bachmeyer, G. Mouchnino, P. Thulliez, L. Blum.
Congenital toxoplasmosis from an HIV-infected woman as a result of reactivation.
J Infect, 52 (2006), pp. e55-e57
[3.]
C.D. Mitchell, S.S. Erlich, M.T. Mastrucci, et al.
Congenital toxoplasmosis occurring in infants perinatally infected with human immunodeficiency virus 1.
Pediatr Infect Dis J, 9 (1990), pp. 512-518
[4.]
P. Marty, A. Bongain, S. Loiseau, et al.
Lethal congenital toxoplasmosis resulting from reactivation of toxoplasmosis in a pregnant HIV-positive patient.
Presse Med, 31 (2002), pp. 1558
[5.]
L. Kodjikian, I. Hoigne, O. Adam, et al.
Vertical transmission of toxoplasmosis from a chronically infected immunocompetent woman.
Pediatr Infect Dis J, 23 (2004), pp. 272-274
[6.]
M.A. Sáfadi, E.N. Berezin, C.K. Farhat, E.S. Carvalho.
Clinical presentation and follow up of children with congenital toxoplasmosis in Brazil.
Braz J Infect Dis, 7 (2003), pp. 325-331
[7.]
European Colaborative Study and Research Network on Congenital Toxoplasmosis.
Low incidence of congenital toxoplasmosis in children born to women infected with human immunodeficiency virus.
Eur J Obstet Gynecol Reprod Bio, 68 (1996), pp. 93-96
[8.]
E.G. Lago, G.S. Conrado, C.S. Piccoli, R.L. Carvalho, A.L. Bender.
Toxoplasma gondii antibody profile in HIV-infected pregnant women and the risk of congenital toxoplasmosis.
Eur J Clin Microbiol Infect Dis, (2008),
[9.]
S.A. Nogueira, E.S. Machado, T.P. Costa, et al.
Co-infection with Toxoplasma gondii in a cohort of HIV infected pregnant women.
Proceedings of the International AIDS Conference,
[10.]
H. Minkoff, J.S. Remington, S.R.N. Holman, et al.
Vertical transmission of toxoplasma by human immunodeficiency virus infected women.
Am J Obstet Gynecol, 176 (1997), pp. 555-559
[11.]
O.N. Mandai, F.M.R. Lopes, R.M. Breganó.
Prevalence of antibodies IgG and IgM anti-Toxoplasma gondii in pregnant women assisted in the unidades básicas de saúde of Londrina – Paraná, in the period of 2003 and 2004.
RBAC, 39 (2007), pp. 247-249
[12.]
K.R. Areal, A.E. Miranda.
Seroprevalence of toxoplasmosis in pregnant women attending primary health care in Vitória.
ES. NewsLab, 87 (2008), pp. 122-129
[13.]
A.M.F. Porto, M.M.R. Amorim, I.C.N. Coelho, L.C. Santos.
Serologic profile of toxoplasmosis in pregnant women attended at a teaching-hospital in Recife.
Rev Ass Med Bras, 54 (2008), pp. 242-248
[14.]
J. Heukelbach, V. Meyer-Cirkel, R.C.S. Moura, et al.
Waterborne toxoplasmosis, Northeastern Brazil.
Emerg Infect Dis, 13 (2007), pp. 287-289
[15.]
K.F. Galisteu, C.B. Mattos, A.G.L. Lelis, et al.
Prevalence and risk factors associated with toxoplasmosis in pregnant women and their children in the Northwest of São Paulo State, Brazil.
Rev Panam Infectol, 9 (2007), pp. 24-29
[16.]
M.L.S. Cruz, C.A.C. Cardoso, M.C. Saavedra, E.D. Santos, T. Melino.
Congenital toxoplasmosis infection in an infant born to an HIV-1-infected mother.
Braz J Infect Dis, 11 (2007), pp. 610-611
[17.]
A.S. Fauci.
The human immunodeficiency virus: infectivity and mechanisms of pathogenesis.
Science, 617 (1988), pp. 617-622
[18.]
M. Lebech, D.H. Joynson, H.M. Seitz, et al.
Classification system and case definitions of Toxoplasma gondii infection in immunocompetent pregnant women and their congenitally infected offspring.
Eur J Clin Microbiol Infect Dis, 15 (1996), pp. 799-805
[19.]
J.G. Montoya.
Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis.
J Infect Dis, 185 (2002), pp. S73-S82
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