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Journal of Clinical Microbiology, October 2004, p. 4765-4768, Vol. 42, No. 10
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.10.4765-4768.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

PCR Assay Using Cerebrospinal Fluid for Diagnosis of Cerebral Toxoplasmosis in Brazilian AIDS patients

José E. Vidal,1 Fabio Antonio Colombo,2 Augusto C. Penalva de Oliveira,3 Roberto Focaccia,1 and Vera Lucia Pereira-Chioccola2*

Department of Infectious Disease,1 Department of Neurology, Instituto de Infectologia Emílio Ribas,3 Department of Parasitology, Instituto Adolfo Lutz, Sao Paulo, Brazil2

Received 2 March 2004/ Returned for modification 12 April 2004/ Accepted 29 June 2004

Highly active antiretroviral therapy has decreased the incidence of opportunistic infections in the central nervous system in AIDS patients. However, neurological abnormalities still remain important causes of mortality and morbidity in developing countries. In Brazil, cerebral toxoplasmosis is the most common cerebral mass lesion in AIDS patients. For these reasons, early, inexpensive, and sensitive diagnostic tests must be evaluated. The aim of this study was to evaluate PCR, using cerebrospinal fluid (CSF) samples to detect Toxoplasma gondii DNA, and to determine if the association of PCR with immunological assays can contribute to a timely diagnosis. We studied two sample groups. First, we analyzed stored CSF samples from 29 newborns and from 39 adults with AIDS without a definitive diagnosis of toxoplasmosis. The goal of this step was to standardize the methodology with a simple and economical procedure to recover the T. gondii DNA. Next, we prospectively evaluated CSF samples from 12 AIDS patients with a first episode of cerebral toxoplasmosis and 18 AIDS patients with other neurological opportunistic diseases and without previous cerebral toxoplasmosis. In all PCR samples, an indirect immunofluorescent assay and an enzyme-linked immunosorbent assay were performed. Samples from all patients with cerebral toxoplasmosis presented positive PCR results (sensitivity, 100%), and a sample from one of the 18 AIDS patients with other neurological diseases also presented positive PCR results (specificity, 94.4%). These findings suggest the clinical utility of PCR in the diagnosis of cerebral toxoplasmosis in developing countries.

* Corresponding author. Mailing address: Laboratório de Parasitologia, Instituto Adolfo Lutz, Av. Dr. Arnaldo, 355 no. 8 andar, CEP 01246-902, São Paulo SP, Brazil. Phone: (55 11) 3068 2889. Fax: (55 11) 3068 2890. E-mail: pchioccola{at}ial.sp.gov.br.

Journal of Clinical Microbiology, October 2004, p. 4765-4768, Vol. 42, No. 10
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.10.4765-4768.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Meira, C. S., Costa-Silva, T. A., Vidal, J. E., Ferreira, I. M. R., Hiramoto, R. M., Pereira-Chioccola, V. L. (2008). Use of the serum reactivity against Toxoplasma gondii excreted-secreted antigens in cerebral toxoplasmosis diagnosis in human immunodeficiency virus-infected patients. J Med Microbiol 57: 845-850 [Abstract] [Full Text]  
  • Joss, A W L, Evans, R, Mavin, S, Chatterton, J, Ho-Yen, D O (2008). Development of real time PCR to detect Toxoplasma gondii and Borrelia burgdorferi infections in postal samples. J. Clin. Pathol. 61: 221-224 [Abstract] [Full Text]  
  • Khan, A., Su, C., German, M., Storch, G. A., Clifford, D. B., Sibley, L. D. (2005). Genotyping of Toxoplasma gondii Strains from Immunocompromised Patients Reveals High Prevalence of Type I Strains. J. Clin. Microbiol. 43: 5881-5887 [Abstract] [Full Text]  
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