RELAPSE OF BRAIN TOXOPLASMOSIS IN 15 AIDS PATIENTS

Relapse of brain toxoplasmosis in AIDS patients continue to occur desp ite maintenance therapy. The characteristics of 15 patients who experi enced a relapse were reviewed. Mean delay of relapse was 7 months (2-2 0). Maintenance therapy for the 2 months prior to the relapse was pyri methamine alone (n = 4), pyrimethamine plus dapsone (n = 3), pyrimetha mine plus spiramycine (n = 1), pyrimethamine plus clindamycine (n = 4) , pyrimethamine plus sulfadiazine (n = 1) and no treatment (n = 2). St rict compliance was as certained for only 5 patients. Compared with th e first episode of brain toxoplasmosis, all 15 patients had new neurol ogical signs, and new lesions of the brain were defected by CT scan in 67% patients. This study showed that poor compliance to maintenance t herapy is a major factor of relapse, and the less favourable response to acute therapy could be due to progression of immunodeficiency.