Prevalencia de mortalidad asociada a Toxoplasma gondii en pacientes adultos con VIH: Estudio retrospectivo en un hospital de Guatemala

Abstract

Introduction: Toxoplasma gondii is a protozoan that causes toxoplasmosis, an opportunistic infection prevalent in HIV-infected patients, particularly those with advanced immunodeficiency. Cerebral toxoplasmosis, a severe form of the disease, has been associated with a high mortality rate in this population. Objective: To determine the prevalence of Toxoplasma gondii-associated mortality in adult HIV-infected patients and describe its immunological and virological characteristics. Methodology: A descriptive, cross-sectional, retrospective study was conducted using data recorded in the institutional database in 103 adult HIV-infected patients treated at the Dr. Carlos Rodolfo Mejía Villatoro HIV and Chronic Infections Unit of Roosevelt Hospital from 2003 to 2023 and who died during that period. The data were processed and analyzed using IBM SPSS Statistics version 27. Absolute frequencies and percentages were calculated for categorical variables; For numerical variables, the median and the Q1 and Q3 percentiles were calculated. Results: The study population was predominantly male (63,1%), with a median age of 35,0 years. Mortality attributed to Toxoplasma gondii increased starting in 2015, peaking in 2016 with 20 deaths (10,5%). The median initial CD4+ T lymphocyte count was 52 cells/µL, decreasing to 37 cells/µL at the end of follow-up. The median initial HIV viral load was 105,502 cp/mL, decreasing to 98,911 cp/mL at the end of follow-up. Conclusion: The results obtained demonstrate the importance of early diagnosis and appropriate clinical management of cerebral toxoplasmosis in order to reduce mortality associated with this infection in immunocompromised patients.