Korean J Med > Volume 76(6); 2009 > Article
The Korean Journal of Medicine 2009;76(6):713-721.
Clinical characteristics and prevalence of toxoplasma infection in human immunodeficiency virus-infected patients in South Korea
Sang Hyun Lee, Sun Hee Lee, Dong Hyuk Cha, Su Jin Lee, Ihm Soo Kwak, Joo Seop Chung, Goon Jae Cho, Hyuck Lee, Dong Sik Jung, Chi Sook Moon, Ji Young Park, Ock Bae Ko, Kang Dae Shin
우리나라 사람면역결핍바이러스 감염 환자의 톡소포자충 감염
이상현, 이선희, 차동혁, 이수진, 곽임수, 정주섭, 조군제, 이 혁, 정동식, 문치숙, 박지영, 고옥배, 강대신
Abstract
Background/Aims: Toxoplasmic encephalitis (TE) is one of the most common causes of focal brain lesions, which complicate the course of acquired immunodeficiency syndrome (AIDS). There is wide geographic variation in the prevalence of toxoplasma infection. This study was performed to characterize toxoplasma infection in human immunodeficiency virus (HIV)-infected patients in South Korea. Methods: We retrospectively examined the incidence and clinical characteristics of TE in 683 HIV-infected patients who were enrolled between 1990 and 2008 at four university hospitals in Busan, Korea. We also assessed the seroprevalence of IgG antibodies to Toxoplasma gondii, risk factors for toxoplasma seropositivity, and seroconversion rates during the course of HIV infection. Results: Among 683 HIV-infected patients, six (0.9%) patients were diagnosed with TE. The incidence of TE was 0.34 per 100 person-years (py) during the study period. Of the 414 patients who had undergone serological examinations for Toxoplasma gondii, 35 (8.5%) patients were seropositive. Univariate analysis showed that the risk factors associated with toxoplasma seropositivity included increased age, heterosexual transmission, marriage, and a history of overseas residence (p<0.05). Of these factors, a history of overseas residence was a significant risk factor in a multivariate analysis (p<0.05). A total of 95 patients who were seronegative on their initial screen showed serial toxoplasma IgG antibodies (mean duration of follow-up, 2.1 years). Among these patients, only two (2.1%) acquired IgG antibodies to Toxoplasma gondii during the follow-up period. Conclusions: The seroprevalence of anti-toxoplasma IgG antibodies in HIV-infected patients in Korea was 8.5%. A history of overseas residence was a significant risk factor for toxoplasma seropositivity. The incidence of TE was 0.34/100 py, which is lower than that reported in other countries. Toxoplasma seroconversion was also uncommon (2.1%).
Key Words: HIV; Toxoplasma gondii; Toxoplasmic encephalitis; Seroprevalence


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