In Vitro Anti-Toxoplasma Gondii Antibody Production by Peripheral Blood Mononuclear Cells in the Diagnosis and the Monitoring of Toxoplasmic Encephalitis in AIDS-Related Brain Lesions

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Abstract
The spontaneous secretion in vitro of anti-Toxoplasma gondii antibodies by peripheral blood mononuclear cells was assessed in 69 patients with AIDS-related brain lesions. The sensitivity and specificity of this assay in the diagnosis of toxoplasmic encephalitis (TE) were found to be 85.4% and 92.8%, respectively. Twenty-four patients with TE were observed during 1-year follow-up after initiation of antiToxoplasma treatment and classified on the basis of their clinical and radiologic responses as sustained responders (SR; n = 11), incomplete responders (IR; n = 7) or transient responders (TR; n = 6). In vitro anti-T. gondii antibody secretion decreased as early as the first month after initiation of treatment and disappeared within the year in SRs, persisted in IRs, and decreased but rebounded at relapse in the TR patients. In vitro anti-T. gondii antibody, which reflects immune system activation by parasitic antigens, could be a surrogate marker of TE in AIDS patients. Address correspondence and reprint requests to Jean-Pierre Vendrell, Service de Bactériologie-Virologie, Hôpital Lapeyronie, 371 Avenue du Doyen Giraud, 34060 Montpellier, Cedex 5, France; e-mail: [email protected] Manuscript received December 2, 1999; accepted July 17, 2000. © 2000 Lippincott Williams & Wilkins, Inc.