LOW INCIDENCE OF CONGENITAL TOXOPLASMOSIS IN CHILDREN BORN TO WOMEN INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

In children born to immunocompetent women, congenital toxoplasmosis al most always results from primary infection during pregnancy. However, reactivation of latent toxoplasmosis during pregnancy could occur in H IV-infected pregnant women, particularly in those who are severely imm unocompromised, and result in maternal-fetal transmission of the paras ite. This mode of infection has been described in case reports but the risk of transmission is unknown. Findings on toxoplasmosis are presen ted from the European Collaborative Study, a prospective study of chil dren born to women known to be HIV-infected at the time of delivery. I n 1058 children followed for a mean duration of 35 months, only one ch ild developed clinical toxoplasmosis. This child was HIV-infected, sev erely immunocompromised, and acquired toxoplasmosis postnatally. Conge nital infection was excluded serologically in a subgroup of 167 childr en, of whom an estimated 71 had been at risk of infection. These clini cal and serological findings indicate a low general risk of maternal-f etal transmission of Toxoplasma infection in HIV-infected women. It is not possible to draw conclusions about the risk of transmission for s everely immunocompromised HIV-infected women because most women in the study were asymptomatic.