Toxoplasma baseline screening in HIV infected patients

 Following the diagnosis of HIV infection, patients are screened to establish their toxoplasma status.

 1. Patients without serological evidence of exposure to toxoplasmosis should be given appropriate health education to reduce the incidence of primary toxoplasmosis.

 2. Patients with serological evidence of previous exposure to toxoplasmosis (IgG positive, IgM negative), are at risk of secondary reactivation, particularly when the CD4 count falls below 200/cu mm. Prophylactic treatment may be considered for this group.

 3. In patients with serological evidence of recent toxoplasma infection (IgG positive, IgM positive), the risk of severe disease is proportional to the degree of immune suppression and specific therapy should be given to selected cases. Specific IgM is rarely detected by ELISA in cases with reactivated infection.