<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1996-3696</journal-id>
<journal-title><![CDATA[Revista del Instituto de Medicina Tropical]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Inst. Med. Trop.]]></abbrev-journal-title>
<issn>1996-3696</issn>
<publisher>
<publisher-name><![CDATA[Instituto de Medicina Tropical]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1996-36962024000200044</article-id>
<article-id pub-id-type="doi">10.18004/imt/2024.19.2.5</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Características clínico-epidemiológicas de toxoplasmosis en sistema nervioso central de pacientes con VIH que acuden al Instituto de Medicina Tropical. Enero a diciembre 2023]]></article-title>
<article-title xml:lang="en"><![CDATA[Clinical-epidemiological characteristics of toxoplasmosis in the central nervous system of HIV patients attending the Institute of Tropical Medicine. January to December 2023]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gaona Lerea]]></surname>
<given-names><![CDATA[María Belén]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Estigarribia]]></surname>
<given-names><![CDATA[Gustavo Benítez]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cardozo]]></surname>
<given-names><![CDATA[Miguel Angel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almirón]]></surname>
<given-names><![CDATA[Desirée]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Instituto de Medicina Tropical ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Previsión Social Hospital Central Servicio de Infectología]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Instituto de Medicina Tropical Dirección Médica]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<volume>19</volume>
<numero>2</numero>
<fpage>44</fpage>
<lpage>50</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1996-36962024000200044&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1996-36962024000200044&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1996-36962024000200044&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Introducción: Entre el 10% y el 50% de las personas con VIH que también presentan serología positiva para Toxoplasma desarrollan encefalitis toxoplásmica (ET). Aproximadamente el 50% de estos casos presentan secuelas neurológicas y la mortalidad se aproxima al 20%. Debido a estos datos, la ET se posiciona como la segunda infección oportunista más frecuente que afecta el sistema nervioso central (SNC) en pacientes VIH positivos. Objetivo: Describir las características clínico-epidemiológicas y evolución de la toxoplasmosis en pacientes portadores de VIH atendidos en el Instituto de Medicina Tropical durante enero a diciembre del 2023. Metodología: Estudio observacional, descriptivo, retrospectivo, de corte transversal. Se incluyeron pacientes con confirmación serológica laboratorial de infección por VIH; mayores de 18 años; con sospecha clínica de infección en el sistema nervioso central por Toxoplasmas gondii, atendidos en el Instituto de Medicina Tropical de enero a diciembre del 2023. Variables de interés: sociodemográficas: edad, sexo, procedencia; laboratoriales: carga viral de VIH, recuento de linfocitos tCD4; variables clínicas: signos y síntomas asociados, desenlace. Los datos fueron procesados en Excel 2010; las variables cualitativas se expresaron en frecuencias absolutas y relativas, y las cuantitativas en medias. Resultados: Fueron incluidos 44 pacientes adultos, edad media 38 años; 66% correspondieron al sexo masculino. 48% de los casos procedentes del Departamento Central. La cefalea fue el síntoma más frecuente: 19 pacientes (43%), seguido de las convulsiones y las focalizaciones neurológicas. La media del recuento de linfocitos tCD4 fue de 79 cel./UL (min: 3, máx:334; RIC:27-104). 41 pacientes (93%) con conteo linfocitario menor a 200 cel/mm3. La media de CV fue de 421865 copias/mL. En el 95,6% de los casos los pacientes recibieron tratamiento médico con trimetoprima sulfametoxazol. En 40,9% se observó hipo densidad en dedo de guante por tomografía axial computarizada, 2,2% presentó proceso expansivo por el mismo método y 6,8% presentaron hipo densidad en resonancia magnética. El 90,9% de los pacientes fueron dados de alta médica. Conclusión: Predominaron adultos jóvenes de sexo masculino, con cefalea como síntoma más frecuente, en su mayoría con una disminución significativa del recuento de linfocitos TCD4. La implementación del tratamiento médico mejoró la respuesta clínica, disminuyendo las complicaciones neurológicas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Introduction: Between 10% and 50% of people with HIV who also have positive serology for Toxoplasma develop toxoplasmic encephalitis (TE). Approximately 50% of these cases present neurological sequelae and mortality approaches 20%. Due to these data, TE is positioned as the second most frequent opportunistic infection that affects the central nervous system (CNS) in HIV-positive patients. Objective: To describe the clinical-epidemiological characteristics and evolution of toxoplasmosis in patients with HIV treated at the Institute of Tropical Medicine from January to December 2023. Methodology: Observational, descriptive, retrospective, cross-sectional study. Patients with laboratory serological confirmation of HIV infection were included; over 18 years of age; with clinical suspicion of central nervous system infection by Toxoplasmas gondii, treated at the Institute of Tropical Medicine from January to December 2023. Variables of interest: sociodemographic: age, sex, origin; laboratory: HIV viral load, tCD4 lymphocyte count; clinical variables: associated signs and symptoms, outcome. The data were processed in Excel 2010; qualitative variables were expressed in absolute and relative frequencies, and quantitative variables in means. Results: 44 adult patients were included, mean age 38 years; 66% were male. 48% of cases came from the Central Department. Headache was the most frequent symptom: 19 patients (43%), followed by seizures and neurological focalizations. The mean CD4 t lymphocyte count was 79 cells/UL (min: 3, max: 334; IQR: 27-104). 41 patients (93%) had a lymphocyte count less than 200 cells/mm3. The mean VL was 421,865 copies/mL. In 95.6% of the cases, the patients received medical treatment with trimethoprim sulfamethoxazole. In 40.9%, hypodensity was observed in the glove finger by computed axial tomography, 2.2% presented an expansive process by the same method and 6.8% presented hypodensity in magnetic resonance imaging. 90.9% of the patients were discharged from the hospital. Conclusion: Young male adults predominated, with headache as the most frequent symptom, mostly with a significant decrease in the CD4 t lymphocyte count. The implementation of medical treatment improved the clinical response, decreasing neurological complications.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Toxoplasmosis cerebral]]></kwd>
<kwd lng="es"><![CDATA[Toxoplasma gondii]]></kwd>
<kwd lng="es"><![CDATA[Virus de inmunodeficiencia humana.]]></kwd>
<kwd lng="en"><![CDATA[Cerebral toxoplasmosis]]></kwd>
<kwd lng="en"><![CDATA[Toxoplasma gondii]]></kwd>
<kwd lng="en"><![CDATA[Human immunodeficiency virus.]]></kwd>
</kwd-group>
</article-meta>
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