Toxoplasmosis (toxo) is an illness caused by a protozoa<\/strong>.<\/p>\n Toxo is mainly transmitted by eating raw or under-cooked meat, or through exposure to cat faeces that is more than 1 day old<\/strong>.<\/p>\n Many adults have been exposed to toxo. But there is usually a risk of illness only when CD4 levels are below 200 cells\/mm3<\/sup>.<\/p>\n If untreated, toxo can be fatal.<\/p>\n Toxo usually affects the brain (toxoplasma encephalitis). Symptoms include:<\/p>\n Toxo can affect organs, including the eyes and lungs.<\/p>\n Diagnosis is difficult. Blood tests for antibodies, and even viral load tests in CSF (cerebrospinal fluid) are not always positive. Brain scans can highlight any damage to the brain, but rarely provide enough information to diagnose the cause of the damage.<\/p>\n Symptoms are often sufficient to start treatment. If symptoms improve within 2 weeks then toxoplasmosis will have been the cause. A brain scan will show reduced damage within 3 weeks.<\/p>\n After a successful response to treatment (usually three weeks) maintenance therapy<\/strong> is continued with low dose <\/strong>pyrimethamine plus either sulphadiazine or clindamycin. This is called secondary prophylaxis<\/strong>.<\/p>\n Treatment is life-long while CD4 count remains below 200.<\/p>\n Treatment can be safely stopped sometimes<\/strong> if ART increases the CD4 count over 200<\/strong>. This also depends on the severity of the previous illness.<\/p>\n Primary prophylaxis is when treatment is used to prevent an initial infection. It is recommended in all people living with HIV who have a CD4 count under 200.<\/strong><\/p>\n The drugs used to protect against toxo also protect against PCP.<\/p>\n Secondary prophylaxis<\/strong>, is when a treatment is used to prevent a second bout of infection (see treatment section above).<\/p>\n Alternative antibiotics like azithromycin and doxycycline are being studied.<\/strong><\/p>\nMain symptoms<\/h2>\n
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Diagnosis<\/h2>\n
Treatment<\/h2>\n
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Prophylaxis<\/h2>\n
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Research and links<\/h2>\n