Lago E G, Conrado G S, Piccoli C S, Carvalho R L, Bender A L
Department of Pediatrics, Pontifícia Universidade Católica do Rio Grande do Su, Porto Alegre, Brazil.
Eur J Clin Microbiol Infect Dis. 2009 Apr;28(4):345-51. doi: 10.1007/s10096-008-0631-2. Epub 2008 Oct 15.
The purpose of this study was to investigate the antibodies to Toxoplasma gondii in human immunodeficiency virus (HIV)-infected pregnant women and to determine the association between serological profile and the risk of congenital toxoplasmosis. The study, conducted in a public maternity ward from May 2002 to April 2005, included all HIV-infected women who delivered live infants during the 36 months, and, as a control group, all HIV-negative women that delivered live infants in the first 12 months of the study. Antibodies to T. gondii were detected in 1,624 of 2,421 HIV-negative women (67%; 95% confidence interval [CI] 65-69%) and in 121 of 168 HIV-infected patients (72%; 95% CI 65-79%). A total of 547 HIV-negative and 103 HIV-infected patients were tested at delivery and had positive T. gondii-specific IgG. In HIV-negative women, the median of the specific IgG concentration was 79 (interquartile range 38-160), and in HIV-infected patients, it was 283 (interquartile range 94-704) (P < 0.001). In the group of co-infected women, the only infant with congenital toxoplasmosis was born to a mother with acute toxoplasmosis infection acquired during pregnancy who did not have a high specific IgG concentration or a positive result for specific IgM. We concluded that high T. gondii-specific IgG values were much more frequent among HIV-infected pregnant women, but it did not translate into an increased risk of maternal-fetal transmission of toxoplasmosis.
本研究的目的是调查人类免疫缺陷病毒（HIV）感染的孕妇中弓形虫抗体情况，并确定血清学特征与先天性弓形虫病风险之间的关联。该研究于2002年5月至2005年4月在一家公立产科病房进行，纳入了在这36个月期间分娩活婴的所有HIV感染女性，作为对照组，纳入了在研究的前12个月内分娩活婴的所有HIV阴性女性。在2421名HIV阴性女性中的1624名（67%；95%置信区间[CI]65 - 69%）以及168名HIV感染患者中的121名（72%；95%CI 65 - 79%）检测到了弓形虫抗体。共有547名HIV阴性和103名HIV感染患者在分娩时接受检测，弓形虫特异性IgG呈阳性。在HIV阴性女性中，特异性IgG浓度中位数为79（四分位间距38 - 160），在HIV感染患者中为283（四分位间距94 - 704）（P < ＜0.001）。在合并感染的女性组中，唯一一名先天性弓形虫病婴儿的母亲是在孕期获得急性弓形虫感染，其特异性IgG浓度不高且特异性IgM检测结果为阴性。我们得出结论，HIV感染的孕妇中弓形虫特异性IgG高值更为常见，但这并未转化为母婴传播弓形虫病风险的增加。
