Impact of HIV-induced immunosuppression on the reactivation of toxoplasmosis: immunopathological aspects, diagnostic challenges, and clinical implications
Impact of HIV-induced immunosuppression on the reactivation of toxoplasmosis: immunopathological aspects, diagnostic challenges, and clinical implications
DOI:
https://doi.org/10.51473/rcmos.v1i2.2025.1591Keywords:
HIV. Toxoplasma gondii. Neurotoxoplasmosis. Coinfection. Immunity.Abstract
The coinfection of Human Immunodeficiency Virus (HIV) and Toxoplasma gondii represents a major clinical and public health challenge due to the high morbidity and mortality associated with neurotoxoplasmosis. This study aimed to discuss the impacts of HIV-induced immunosuppression on T. gondii reactivation, focusing on immunological mechanisms, diagnostic challenges, and clinical implications of the coinfection. A narrative literature review was conducted, qualitative and descriptive in nature, based on articles published between 2010 and 2025 in PubMed, SciELO, LILACS, and Google Scholar. Findings revealed that the progressive depletion of CD4+ T lymphocytes, associated with CD8+ dysfunction and impaired NK cell activity, favors parasite reactivation. Neurotoxoplasmosis emerged as a severe complication, characterized by high mortality and permanent neurological sequelae, further aggravated by diagnostic limitations in low-resource settings. Moreover, poor adherence to antiretroviral therapy and inequities in healthcare access were identified as critical factors. In conclusion, despite recent advances, significant gaps remain regarding the detailed understanding of immune mechanisms and the availability of accessible diagnostic strategies. This highlights the urgent need for integrated public health policies, improved adherence to ART, and multicenter research that may support effective interventions.
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. Acesso em: 5 maio 2025.
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