Risk factors of Toxoplasma encephalitis among people living with HIV/AIDS at Wangaya hospital in Denpasar, Bali, Indonesia: a case control study

Abstract

Background: Toxoplasma encephalitis (TE) is the most frequent AIDS-related opportunistic infection. T. gondii infects the human population in both developed and developing countries. Toxoplasmosis among PLWHA manifests primarily as a life-threatening condition, TE, brain abscesses and death. Objective was to identify the risk factors of Toxoplasma encephalitis (TE) among people living with HIV/AIDS (PLWHA).  Methods: A case control study was conducted during May to November 2018. The study participants consisted of 90 PLWHA; 30 PLWHA with history of TE (cases) and 60 PLWHA without history of TE (controls). Data such as: socio-demographic, laboratory results, head CT scan findings were collected from the medical record and was analyzed using SPSS version 18.Results: A total of 90 participants PLWHA were enrolled, 30 participants as cases and 60 participants as a control. 49 (54.4%) participants were males and 41 (45.6%) participants were females. Among the risk factors evaluated; the lower lymphocyte level (p=0.016), the lower cluster differentiation (CD) 4 level (p=0.003), no taking highly active antiretroviral therapy (HAART) (p=0.000) were observed to be an independent associated risk factor of TE.Conclusions: Our findings suggest lower lymphocyte levels, lower CD4 count and no taking HAART may constitute a significant associated risk factor for TE in PLWHA.