8.2.3
Toxoplasmosis
Clinical HIV Guidelines, 5th Edition, 2022. Chapter 8, HIV-related diseases.
Signs and symptoms
New convulsions, possibly reduced consciousness, focal neurological symptoms Very unlikely in patients with CD4 above 200 cells/ml
Investigations
Brain CT or MRI scan where possible.
Treatment
Clinical improvement on this treatment makes toxoplasmosis very likely.
Start ART after 4 weeks to prevent toxoplasmosis IRIS.
Pharmacological
Cotrimoxazole tablets Adult: 2 x 960 mg tabs 12-hourly for 6 weeks, then 1 x 960 mg tab 12-hourly for 3 months, then 1 x 960 mg tab 24-hourly for life Child: Call DHA for paediatric dosing Alternative regimen: if cotrimoxazole is not tolerated Clindamycin tablets 600mg 6-hourly for 6 weeks + Pyrimethamine tablets 200 mg on day one 50mg 24-hourly for 6 weeks
Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.
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