Toxoplasmosis screening
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Majority of the countries do not follow standard screening for the detection of toxoplasma infection during the antenatal period. Women are tested for antibodies aganist toxoplasma on their first antenatal visit, and if they are seropositive they are followed up periodically in every trimester to examine the trends in IgG titer levels. All HIV-infected patients should be tested for prior exposure by measuring anti-Toxoplasma IgG. Patients with HIV and CD4+ T lymphocyte counts <100 cells/microliter with detectable anti-Toxoplasma IgG are at risk for reactivation of latent infection and should receive prophylactic treatment. Screening for toxoplasma is routinely performed for cardiac donors.[1]
Screening
Pregnant women and Newborns
- Majority of the countries do not follow standard screening for the detection of toxoplasma infection during the antenatal period.
- In countries such as France, Austria, Brazil standard screening is followed during the antenatal period for detecton of toxoplasmosis .[2]
- Women are tested for antibodies aganist toxoplasma on their first antenatal visit, and if they are seropositive they are followed up periodically in every trimester to examine the trends in IgG titer levels.[1]
- Women who seroconvert during gestation, fetal testing by amniocentesis and fetal blood sampling is recommended to identify the infection status in the fetus.
HIV infected patients
- All HIV-infected patients should be tested for prior exposure by measuring anti-Toxoplasma IgG.
- If previously seronegative and if the patient is unable to take trimethoprim/sulfamethoxazole for Pneumocystis jiroveci prophylaxis, serology should be repeated when the CD4+ T lymphocyte count nears 100 cells/microliter.
- Patients with HIV and CD4+ T lymphocyte counts <100 cells/microliter with detectable anti-Toxoplasma IgG are at risk for reactivation of latent infection and should receive prophylactic treatment.
Transplant patients
- Screening for Toxoplasma is routinely performed for cardiac donors.
- Prophylaxis is indicated for patients who have detectable anti-Toxoplasma IgG or who are recipients of hearts from seropositive donors.
- All recipients of allogeneic hematopoietic stem cell transplants should have baseline anti-Toxoplasma IgG testing.
- Seropositive recipients with active graft versus host disease (GVHD) or with a history of toxoplasmic chorioretinitis should receive prophylaxis.
References
- ↑ 1.0 1.1 Berghold, Christian; Herzog, Sereina Annik; Jakse, Heidelinde; Berghold, Andrea (2016). "Prevalence and incidence of toxoplasmosis: a retrospective analysis of mother-child examinations, Styria, Austria, 1995 to 2012". Eurosurveillance. 21 (33). doi:10.2807/1560-7917.ES.2016.21.33.30317. ISSN 1025-496X.
- ↑ Doğan K, Kafkaslı A, Karaman U, Atambay M, Karaoğlu L, Colak C (2012). "[The rates of seropositivity and seroconversion of toxoplasma infection in pregnant women]". Mikrobiyol Bul. 46 (2): 290–4. PMID 22639318.