Cerebral toxoplasmosis in the twenty-first century: long-term clinical outcomes in a retrospective cohort study in the Netherlands

C. M. van Deuzen; B. J.A. Rijnders; H. I. Bax; C. Rokx; T. E.M.S. de Vries-Sluijs; C. A.M. Schurink; J. L. Nouwen; M. de Mendonça-Melo; A. A. Anas; E. van Gorp; L. Slobbe; J. J. van Hellemond; E. van Nood

doi:10.1097/QAD.0000000000004356

Cerebral toxoplasmosis in the twenty-first century: long-term clinical outcomes in a retrospective cohort study in the Netherlands

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Abstract

Background:

– Cerebral toxoplasmosis is a common opportunistic infection in people with HIV (PWH), associated with high morbidity and mortality. It is unclear how clinical characteristics, treatment response and long-term clinical outcomes in PWH with cerebral toxoplasmosis have changed due to improved treatment of HIV.

Methods:

– This single-centre retrospective observational cohort study of PWH with cerebral toxoplasmosis included patients over almost 25 years.

Results:

– 63 eligible patients were identified. Most patients were late presenters presenting with headache and neurological symptoms. Overall survival was 79% over a mean follow up of 15 years. 73% of deaths occurred within the first year after diagnosis. Almost 10% of patients experienced residual impairments.

Conclusions:

– An earlier diagnosis of HIV reduces the incidence of cerebral toxoplasmosis due to timely initiation of cART and anti-Toxoplasma prophylaxis. High index of suspicion by clinicians is vital to timely start anti-Toxoplasma therapy. If treated correctly and timely, overall survival is high.

Original language	English
Journal	AIDS
Volume	Publish Ahead of Print
DOIs	https://doi.org/10.1097/QAD.0000000000004356
Publication status	Published - 23 Sept 2025

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Publisher Copyright:
© 2025

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van Deuzen, C. M., Rijnders, B. J. A., Bax, H. I., Rokx, C., de Vries-Sluijs, T. E. M. S., Schurink, C. A. M., Nouwen, J. L., de Mendonça-Melo, M., Anas, A. A., van Gorp, E., Slobbe, L., van Hellemond, J. J., & van Nood, E. (2025). Cerebral toxoplasmosis in the twenty-first century: long-term clinical outcomes in a retrospective cohort study in the Netherlands. AIDS, Publish Ahead of Print. https://doi.org/10.1097/QAD.0000000000004356

@article{a92b93ceb05d4c40a808f05822360369,

title = "Cerebral toxoplasmosis in the twenty-first century: long-term clinical outcomes in a retrospective cohort study in the Netherlands",

abstract = " Background: – Cerebral toxoplasmosis is a common opportunistic infection in people with HIV (PWH), associated with high morbidity and mortality. It is unclear how clinical characteristics, treatment response and long-term clinical outcomes in PWH with cerebral toxoplasmosis have changed due to improved treatment of HIV. Methods: – This single-centre retrospective observational cohort study of PWH with cerebral toxoplasmosis included patients over almost 25 years. Results:– 63 eligible patients were identified. Most patients were late presenters presenting with headache and neurological symptoms. Overall survival was 79\% over a mean follow up of 15 years. 73\% of deaths occurred within the first year after diagnosis. Almost 10\% of patients experienced residual impairments. Conclusions: – An earlier diagnosis of HIV reduces the incidence of cerebral toxoplasmosis due to timely initiation of cART and anti-Toxoplasma prophylaxis. High index of suspicion by clinicians is vital to timely start anti-Toxoplasma therapy. If treated correctly and timely, overall survival is high.",

author = "\{van Deuzen\}, \{C. M.\} and Rijnders, \{B. J.A.\} and Bax, \{H. I.\} and C. Rokx and \{de Vries-Sluijs\}, \{T. E.M.S.\} and Schurink, \{C. A.M.\} and Nouwen, \{J. L.\} and \{de Mendon{\c c}a-Melo\}, M. and Anas, \{A. A.\} and \{van Gorp\}, E. and L. Slobbe and \{van Hellemond\}, \{J. J.\} and \{van Nood\}, E.",

note = "Publisher Copyright: {\textcopyright} 2025",

year = "2025",

month = sep,

day = "23",

doi = "10.1097/QAD.0000000000004356",

language = "English",

volume = "Publish Ahead of Print",

journal = "AIDS",

issn = "0269-9370",

publisher = "Lippincott Williams \& Wilkins",

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van Deuzen, CM , Rijnders, BJA , Bax, HI , Rokx, C , de Vries-Sluijs, TEMS , Schurink, CAM , Nouwen, JL , de Mendonça-Melo, M , Anas, AA , van Gorp, E , Slobbe, L , van Hellemond, JJ & van Nood, E 2025, 'Cerebral toxoplasmosis in the twenty-first century: long-term clinical outcomes in a retrospective cohort study in the Netherlands', AIDS, vol. Publish Ahead of Print. https://doi.org/10.1097/QAD.0000000000004356

TY - JOUR

T1 - Cerebral toxoplasmosis in the twenty-first century

T2 - long-term clinical outcomes in a retrospective cohort study in the Netherlands

AU - van Deuzen, C. M.

AU - Rijnders, B. J.A.

AU - Bax, H. I.

AU - Rokx, C.

AU - de Vries-Sluijs, T. E.M.S.

AU - Schurink, C. A.M.

AU - Nouwen, J. L.

AU - de Mendonça-Melo, M.

AU - Anas, A. A.

AU - van Gorp, E.

AU - Slobbe, L.

AU - van Hellemond, J. J.

AU - van Nood, E.

PY - 2025/9/23

Y1 - 2025/9/23

N2 - Background: – Cerebral toxoplasmosis is a common opportunistic infection in people with HIV (PWH), associated with high morbidity and mortality. It is unclear how clinical characteristics, treatment response and long-term clinical outcomes in PWH with cerebral toxoplasmosis have changed due to improved treatment of HIV. Methods: – This single-centre retrospective observational cohort study of PWH with cerebral toxoplasmosis included patients over almost 25 years. Results:– 63 eligible patients were identified. Most patients were late presenters presenting with headache and neurological symptoms. Overall survival was 79% over a mean follow up of 15 years. 73% of deaths occurred within the first year after diagnosis. Almost 10% of patients experienced residual impairments. Conclusions: – An earlier diagnosis of HIV reduces the incidence of cerebral toxoplasmosis due to timely initiation of cART and anti-Toxoplasma prophylaxis. High index of suspicion by clinicians is vital to timely start anti-Toxoplasma therapy. If treated correctly and timely, overall survival is high.

AB - Background: – Cerebral toxoplasmosis is a common opportunistic infection in people with HIV (PWH), associated with high morbidity and mortality. It is unclear how clinical characteristics, treatment response and long-term clinical outcomes in PWH with cerebral toxoplasmosis have changed due to improved treatment of HIV. Methods: – This single-centre retrospective observational cohort study of PWH with cerebral toxoplasmosis included patients over almost 25 years. Results:– 63 eligible patients were identified. Most patients were late presenters presenting with headache and neurological symptoms. Overall survival was 79% over a mean follow up of 15 years. 73% of deaths occurred within the first year after diagnosis. Almost 10% of patients experienced residual impairments. Conclusions: – An earlier diagnosis of HIV reduces the incidence of cerebral toxoplasmosis due to timely initiation of cART and anti-Toxoplasma prophylaxis. High index of suspicion by clinicians is vital to timely start anti-Toxoplasma therapy. If treated correctly and timely, overall survival is high.

UR - https://www.scopus.com/pages/publications/105023648935

U2 - 10.1097/QAD.0000000000004356

DO - 10.1097/QAD.0000000000004356

M3 - Article

C2 - 40985660

AN - SCOPUS:105023648935

SN - 0269-9370

VL - Publish Ahead of Print

JO - AIDS

JF - AIDS

ER -

Cerebral toxoplasmosis in the twenty-first century: long-term clinical outcomes in a retrospective cohort study in the Netherlands

Abstract

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