International Journal of Advances in Medicine | November 2020 | Vol 7 | Issue 11 Page 1622
International Journal of Advances in Medicine
Suharsono H et al. Int J Adv Med. 2020 Nov;7(11):1622-1625
http://www.ijmedicine.com
pISSN 2349-3925 | eISSN 2349-3933
Original Research Article
Risk factors of Toxoplasma encephalitis among people living with
HIV/AIDS at Wangaya hospital in Denpasar, Bali, Indonesia:
a case control study
Hamong Suharsono
1
, Ketut Suryana
2
*, Mochamad P. Pujasakti
3
INTRODUCTION
Toxoplasma encephalitis (TE) is the most frequent AIDS-
related opportunistic infection. T. gondii infects
approximately 30 to 50% of the human population in
both developed and developing countries.
1-5
In majority
of immunocompetent human hosts, T. gondii ensue a
latent infection characterized by the persistence of
organism in tissues such as brain, skeletal muscles and
heart without any signs and stmptoms.
3,6,7
In chronically
infected individuals who develop defects in cell-mediated
immunity/immunocompromised patients/patients infected
with HIV, a symptomatic disease more likely occurs as a
result of reactivation of latent infection, especially if their
CD4 count decreases below 200 cells/μl.
8
Toxoplasmosis
among PLWHA manifests primarily as a life threatening
condition, TE, brain abscesses and death.
9,10
Considering that there are no TE associated risk factors
data in our hospital. This study was designed to identify
ABSTRACT
Background: Toxoplasma encephalitis (TE) is the most frequent AIDS-related opportunistic infection. T. gondii
infects the human population in both developed and developing countries. Toxoplasmosis among PLWHA manifests
primarily as a life-threatening condition, TE, brain abscesses and death. Objective was to identify the risk factors of
Toxoplasma encephalitis (TE) among people living with HIV/AIDS (PLWHA).
Methods: A case control study was conducted during May to November 2018. The study participants consisted of 90
PLWHA; 30 PLWHA with history of TE (cases) and 60 PLWHA without history of TE (controls). Data such as:
socio-demographic, laboratory results, head CT scan findings were collected from the medical record and was
analyzed using SPSS version 18.
Results: A total of 90 participants PLWHA were enrolled, 30 participants as cases and 60 participants as a control. 49
(54.4%) participants were males and 41 (45.6%) participants were females. Among the risk factors evaluated; the
lower lymphocyte level (p=0.016), the lower cluster differentiation (CD) 4 level (p=0.003), no taking highly active
antiretroviral therapy (HAART) (p=0.000) were observed to be an independent associated risk factor of TE.
Conclusions: Our findings suggest lower lymphocyte levels, lower CD4 count and no taking HAART may constitute
a significant associated risk factor for TE in PLWHA.
Keywords: People living with HIV/AIDS, Toxoplasma encephalitis, Associated risk factors
1
Department of Biochemistry, Veterinary Faculty of Udayana, University in Denpasar, Bali, Indonesia
2
Department of Medicine, Merpati Clinic, Wangaya HIV Study Group (WHSG), Allergy and Clinical Immunology
Services Unit at Wangaya, Bali, Indonesia
3
Ministry of Research and Technology/National Agency of Research and Innovation, Indonesia
Received: 01 September 2020
Accepted: 06 October 2020
*Correspondence:
Dr. Ketut Suryana,
E-mail: ketutsuryana@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-3933.ijam20204511