Ogoina Dimie, Obiako Reginald O, Onyemelukwe Geoffrey C, Musa Bolanle O, Hamidu Ahmed Umdagas
Department of Medicine, College of Health Sciences, Niger Delta University, Wilberforce Island, Amassoma, Bayelsa, Nigeria.
J Int Assoc Provid AIDS Care. 2014 Jan-Feb;13(1):18-21. doi: 10.1177/2325957413500529. Epub 2013 Aug 20.
Toxoplasma encephalitis (TE) is the most common cause of focal deficits in patients living with HIV/AIDS. Among 257 HIV-infected adult patients seen between January 2006 and December 2010 in a tertiary hospital in Zaria, northern Nigeria, 9 (3.5%) patients had clinical, serological, and brain imaging evidence of TE. All 9 patients had CD4 count of less than 50 cells/mm(3). Of the 9 patients, 7 were antiretroviral therapy (ART)-naive, while 2 were cases of ART-induced TE-immune reconstitution inflammatory syndrome. After administering intravenous dexamethasone for cerebral decompression and specific antitoxoplasma therapy, symptoms and signs resolved in 8 patients within 4 to 14 days, but 1 patient died. Our data suggest that even in the ART era in Nigeria, TE remains a fairly common cause of morbidity among HIV-infected patients due to late HIV diagnosis and significant immunosuppression at diagnosis. Early HIV diagnosis, early initiation of highly active ART, and routine prophylaxis against TE are imperative in combating the challenge of HIV/AIDS-related TE in Nigeria.
弓形虫性脑炎（TE）是艾滋病毒/艾滋病患者局灶性神经功能缺损最常见的病因。在2006年1月至2010年12月期间，尼日利亚北部扎里亚一家三级医院诊治的257例感染艾滋病毒的成年患者中，9例（3.5%）有TE的临床、血清学及脑影像学证据。所有9例患者的CD4细胞计数均低于50个/mm³。9例患者中，7例未接受过抗逆转录病毒治疗（ART），2例为ART诱发的TE免疫重建炎症综合征。在给予静脉注射地塞米松进行脑减压及特异性抗弓形虫治疗后，8例患者的症状和体征在4至14天内消失，但有1例患者死亡。我们的数据表明，即使在尼日利亚的ART时代，由于艾滋病毒诊断延迟及诊断时存在显著免疫抑制，TE仍是艾滋病毒感染患者发病的一个相当常见的病因。在应对尼日利亚与艾滋病毒/艾滋病相关的TE挑战方面，早期艾滋病毒诊断、尽早启动高效ART及常规预防TE势在必行。
