Perfil clínico de pacientes HIV/AIDS coinfectados com toxoplasma gondii do hospital de doenças tropicais da universidade federal do Tocantins (hdt-UFT) no município de Araguaína, Tocantins.

Abstract

Toxoplasma gondii is one of the main etiological agents responsible for the involvement of the Central Nervous System (CNS) in patients immunosuppressed by the HIV. There is an association between T. gondii positivity and CD4 T lymphocyte count, especially when below 200 cells/mm³, with regard to the possibility of developing neurotoxoplasmosis. Screening for parasite positivity is necessary to help reduce either morbidity and mortality than sequelae related to this opportunistic infection. This study aims to evaluate the epidemiological profile of pacients seen in the first outpatient consultation with an infectious disease specialist after a diagnosis of HIV or AIDS, between 2015 and 2019, at the Hospital for Tropical Diseases of the Federal University of Tocantins (HDT-UFT) in Araguaína, Tocantins. This is a qualitative and retrospective study that analyzed medical records based on a data collection spreadsheet developed for this study. The period of data collection and analysis took place between October 2019 and November 2020. A total of 669 medical records were evaluated, of wich 294 medical records were discarded for the purpose of this study because they did not contain serology results for toxoplasmosis, reaching a sample universe of 375 people living with HIV trated at the HDT-UFT. Based on the inclusion/exclusion criteria, 315 positive pacients for toxoplasmosis and 60 negative patients were detected. As for the positive patients, 29 were diagnosed with neurotoxoplasmosis. The results indicate a high rate of infection by T. gondii among patients with HIV/AIDS (84%), with neurotoxoplasmosis being detected in 9,2% of these patients. This research concludes an epidemiological and clinical characterization of toxoplasmosis in HIV/AIDS patients trated in the city of Araguaína, at HDT-UFT. As significant results, a high prevalence of T. gondii infection was identified among the years studied (84%), when compared to states in the Northeast (64% to 79%), North (77%) and Brazil (70%). In additon, 54,28% of patients positive for T. gondii were between 25 and 44 years old, most of them working in professions not related to the field. Most patients had low level of education (76,5% up to high school), and most positive patients had CD4 T cell counts below 350 cells/mm³ (54,7%). The percentage of patients who developed neurotoxoplasmosis was 9,2%, below the rates in states such as Bahia (12,2%), Rio de Janeiro (10,4%) and the city Natal (11,7%). As for the CD4 T cells count for these patients, the prevalence was below 200 cells/mm³ (72,4%). Among the years studied, the atypicality was also identified in 2017, in which there was a peak of cases of development of neurotoxoplasmosis (14,5%), a year in which there was a prevalence of patients with CD4 T lymphocytes counts below 350 cells/mm³.