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Reasons for failure of prevention of Toxoplasma encephalitis. Swiss HIV Cohort Study

Gabriel, V.
Flepp, Markus
von Overbeck, J.
Published in AIDS. 1996, vol. 10, no. 5, p. 509-513
Abstract OBJECTIVE: To study whether absence of prophylaxis is a risk factor for cerebral toxoplasmosis, and to determine the reasons for absence of prophylaxis among AIDS patients diagnosed with Toxoplasma encephalitis (TE). DESIGN: Retrospective chart review and matched case-control study. PATIENTS: Patients (104 first episodes and 26 relapses of TE) were registered in the Swiss HIV Cohort Study from three centres from July 1992 to December 1994; 91 matched controls were included for 52 patients with a first episode, and 17 matched controls for 17 patients with relapse of TE. RESULTS: Prophylaxis was prescribed to 17 patients (16%) with a first episode and 19 patients (73%) with a relapse of TE. Reasons for the absence of prophylaxis included patient refusal (25%), non-proposal by physicians (17%), and drug intolerance (17%). Reduced absorption due to non-compliance, diarrhoea or vomiting was identified among 12 patients with a first episode and 14 patients with a relapse of TE. Absence of prescription of prophylaxis was associated with a 10-fold increased risk of a first episode of TE (odds ratio, 9.8; 95% confidence interval, 2.7-35.4) in the matched case-control study. CONCLUSIONS: TE continues to occur among patients not receiving prophylaxis. At least one-half of the cases may be prevented with better motivation of physicians and increased compliance of patients.
Keywords AIDS-Related Opportunistic Infections/ prevention & controlAdultAntiprotozoal Agents/therapeutic useCohort StudiesEncephalitis/ prevention & controlFemaleHumansMaleMatched-Pair AnalysisRetrospective StudiesRisk FactorsToxoplasmosis, Cerebral/ prevention & control
PMID: 8724042
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VAN DELDEN, Christian et al. Reasons for failure of prevention of Toxoplasma encephalitis. Swiss HIV Cohort Study. In: AIDS, 1996, vol. 10, n° 5, p. 509-513. https://archive-ouverte.unige.ch/unige:7628

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Deposited on : 2010-06-21

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