Prophylaxis

Exposure Prophylaxis: IgG-negative patients can protect themselves from initial infection - they should avoid eating raw or only briefly cooked meat (lamb, beef, pork, game). However, it has not been proven, despite widespread opinion, that HIV patients can infect themselves by mere contact with cats, the definitive host of toxoplasma gondii. The only study that has seriously investigated this to date could not prove endangerment as a result of proximity to cats (Wallace 1993). Nevertheless, hygiene measures should be taken (e.g. use gloves for the cat litter box!). Primary Prophylaxis: All IgG-positive patients with less than 100 CD4 cells/^l require primary prophylaxis. The drug of choice is co-trimoxazole. In cases of allergy, desensitization may be considered (see PCP). Alternatives are dapsone plus pyrimethamine or high-dose dapsone alone. Primary prophylaxes can be discontinued if CD4 cells are above 200/^l for at least three months on HAART.

Treatment/prophylaxis of cerebral toxoplasmosis

(daily doses, if not specified otherwise)

Treatment/prophylaxis of cerebral toxoplasmosis

(daily doses, if not specified otherwise)

Acute therapy

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