Long-term course and outcome in AIDS patients with cerebral toxoplasmosis

Objectives - We compared clinical long-term course and outcome in all AIDS patients admitted to our outpatient department from January, 1989 to June, 1998 with toxoplasma encephalitis (TE) as first AIDS-defining infection (n = 106) and in 106 patients with Pneumocystis carinii pneumonia (PCP) as fir st AIDS-defining disease. Material and methods The 2 groups were matched wi th respect to age, sex, risk group, degree of immunodeficiency as measured by CD4 cell counts and duration of HIV-1-positivity. TE was diagnosed radio logically and by response to treatment. Results - Forty-three TE patients s urviving the first TE symptoms >14 months developed dementive symptoms, leu coencephalopathy in imaging procedures and died from dementia. In contrast only 5 patients surviving PCP for an equally long period showed dementive s ymptoms. Conclusion - Cerebral infections like toxoplasma encephalitis (TE) may negatively influence HIV-1-activity so far latent in the brain.