DETECTION OF TOXOPLASMA-GONDII IN IMMUNODEFICIENT SUBJECTS BY GENE AMPLIFICATION - INFLUENCE OF THERAPEUTICS

Polymerase chain reaction (PCR) technology was used to detect Toxoplas ma gondii DNA in 253 immunodeficient subjects, 179 of whom were infect ed with the human immunodeficiency virus (HIV). The incidence of toxop lasmosis was 12.3% (22/179) in the HIV-infected subjects and 2.7% (2/7 4) in the remainder. The sensitivity of the PCR during episodes of tox oplasmosis in HIV-infected subjects not on antiparasitic treatment was 86.6% on peripheral blood and 60% on cerebrospinal fluid (CSF), but w as only 25% and 16.7%, respectively, in subjects receiving specific tr eatment or prophylaxis against Pneumocystis carinii. Among the HIV-ser onegative population, six patients undergoing anticancer chemotherapy were PCR positive on bronchoalveolar lavage fluid but did not develop pulmonary toxoplasmosis, suggesting transient carriage.