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Molecular diagnosis of Toxoplasma gondii infection in cerebrospinal fluid from AIDS patients

机译:艾滋病患者脑脊液中弓形虫感染的分子诊断

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Background Toxoplasmic encephalitis (TE) is one of the most common opportunistic infections in immunocompromised patients. In Cuba, despite the highly active antiretroviral therapy, TE is still the most important cause of cerebral mass lesions in patients infected with the human immunodeficiency virus (HIV). The detection of Toxoplasma gondii by PCR may facilitate the diagnosis and follow-up of TE in acquired immunodeficiency syndrome (AIDS) patients by direct identification of parasite DNA in clinical samples. The aim of the present study was to evaluate a rapid PCR method using the B1 gene to detect T. gondii in cerebrospinal fluid (CSF) samples from patients with suspected TE. Methods CSF samples from AIDS and HIV-negative patients were analyzed. Patients were divided into two groups according to the Centre for Disease Control and Prevention (CDC) criteria for AIDS-related TE: AIDS patients with suspected neurotoxoplasmosis and AIDS and HIV-negative patients with other confirmed neurological diseases but no suspicions of TE. Predictive values, diagnostic accuracy, sensitivity and specificity of the PCR B1 method were calculated. Results The results obtained from 190 patients showed that this assay has a good sensitivity and specificity (83.3% and 95.7%, respectively) for the diagnosis of TE in AIDS patients. Conclusion PCR using the B1 gene and B22/B23 set of primers is a single, rapid and reliable method that may be valuable for discrimination between toxoplasmosis and other central nervous system (CNS) diseases.
机译:背景弓形体脑炎(TE)是免疫功能低下患者中最常见的机会性感染之一。在古巴,尽管进行了高效的抗逆转录病毒治疗,但TE仍然是感染人类免疫缺陷病毒(HIV)的患者脑部肿块损害的最重要原因。通过直接检测临床样本中的寄生虫DNA,PCR检测弓形虫可有助于对获得性免疫缺陷综合症(AIDS)患者进行TE的诊断和随访。本研究的目的是评估使用B1基因的快速PCR方法来检测疑似TE患者脑脊液(CSF)样品中的弓形虫。方法分析艾滋病和艾滋病毒阴性患者的脑脊液样本。根据美国疾病控制与预防中心(CDC)对与AIDS有关的TE的标准将患者分为两组:疑似神经弓形虫病和AIDS的AIDS患者和其他确诊神经系统疾病但未怀疑TE的HIV阴性患者。计算了PCR B1方法的预测值,诊断准确性,敏感性和特异性。结果从190例患者中获得的结果表明,该方法对于诊断AIDS患者的TE具有良好的敏感性和特异性(分别为83.3%和95.7%)。结论使用B1基因和B22 / B23套引物进行PCR是一种简便,快速,可靠的方法,对于区分弓形虫病和其他中枢神经系统(CNS)疾病可能具有重要的价值。

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