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[Clinical trials of prophylaxis of toxoplasmic retinochoroiditis recurrences by immunotherapy using B.C.G. (author's transl)].

7 patients affected by recurrent retinochoroiditis certainly or probably due to toxoplasma Gondii underwent immunotherapy by B.C.G. The follow-up after immunotherapy varied from 14 months to 50 months with an average of 28 months. 5 out of the 7 patients (71%) had recurrences of the retinochoroiditis 2 months to 3 years after the treatment. Even though the series is small, the results are so discouraging that we do not recommend to go further with this technique. At present we try other forms of immunotherapy. Assessment of their value will require a 5 years follow-up.

Adolescent↗

[Aids and chorioretinal opportunistic infections].

Retrospective study of 19 cases of opportunistic infections of the chorioretina in patients with the Acquired Immunodeficiency Syndrome. We observed 14 cases of CMV retinitis, 2 cases of toxoplasmic chorioretinitis, 1 case of cryptococcal choroiditis and 2 cases of herpes zoster retinitis. Review of the clinical, angiographical and histopathological aspects of these infections. Review of the vital and visual prognosis after treatment.

AIDS-Related Opportunistic Infections↗

Detection of Toxoplasma gondii-specific IgA in the aqueous humor of cats.

Toxoplasma gondii-specific IgA, IgM, and IgG were measured by ELISA in the serum and aqueous humor of 29 client-owned cats with endogenous uveitis and 7 specific-pathogen-free cats tested sequentially for 20 weeks after inoculation with T gondii. Local antibody production in aqueous humor was estimated by multiplying the aqueous humor-to-serum T gondii-specific antibody ratio by the serum-to-aqueous humor total IgG (C value) or calicivirus-specific IgG (CTC value) ratio. Evidence for local production of antibody in aqueous humor was defined as C value greater than 8 or CTC value greater than 1. Toxoplasma gondii-specific IgM CTC values, IgG CTC values, or IgA CTC values greater than 1 were detected in the aqueous humor of 18 of 29 (62.1%) client-owned cats with endogenous uveitis; 2 cats had IgA CTC values greater than 1 without detectable IgM or IgG in aqueous humor. Toxoplasma gondii-specific IgM was not detected in the aqueous humor of experimentally inoculated cats before or after inoculation. Immunoglobulin G C values greater than 8 were detected in all 7 experimentally inoculated cats and ranged from 10.4 to 145.5. Immunoglobulin G C values greater than 8 were first detected 4 to 8 weeks after T gondii inoculation and were undetectable by week 16 after inoculation. Immunoglobulin A C values greater than 8 were detected in 4 of 7 cats and ranged from 12.7 to 264.3. Immunoglobulin A C values greater than 8 were first detected 4 to 8 weeks after inoculation, and were detected in 2 cats during week 20 after inoculation. It was concluded that some cats infected with T gondii develop detectable concentrations of T gondii-specific IgA in aqueous humor.

Animals↗

[Cost-benefit analysis of screening for congenital toxoplasmosis].

A comprehensive cost-benefit analysis of possible screening strategies for congenital toxoplasmosis is necessary as a basis for the decision whether or not screening is efficient and socially desirable. The total costs of the disease in Switzerland were calculated for the year 1990. Direct costs (all diagnostic and therapeutic interventions, including care of handicapped children) and indirect costs (partial and total work losses in the future) were taken into account. Today, the direct costs amount to approx. SFr. 20 mio per year (i.e. approx. SFr. 2.8 mio per million population). The indirect costs were calculated at SFr. 4 mio per year. Moreover, the costs incurred with three possible screening programs (1 test with all pregnant women, with 1, 2 or 5 additional tests, depending on the strategy) were estimated, together with the concomitant cost savings. The financial resources needed for the screenings would amount to SFr. 7 mio-18 mio per year, depending on the strategy chosen. However, the possible savings would be in the range of SFr. 4 mio-12 mio only. The possible savings are, in any case, of the same order of magnitude as the costs for screening. Screening would become cost-efficient if costs for the serological tests could be lowered.

Cost-Benefit Analysis↗