PROPHYLAXIS FOR TOXOPLASMOSIS IN AIDS

Toxoplasmic encephalitis in patients with the acquired immunodeficiency syndrome (AIDS) may result in death even when treated. Identification of the best regimens for most patients awaits carefully designed, prospective, randomized and controlled trials. Such trials are needed because the diverse groups of patients with both AIDS and toxoplasmic encephalitis are affected by numerous confounding factors including prevalence of latent Toxoplasma gondii infection, risk factors for the human immunodeficiency virus (HIV), epidemiologic risk for T. gondii exposure, degree of drug compliance, concurrent opportunistic infections, and prophylactic therapies, Carr and colleagues report in this issue the results of their experience with trimethoprim-sulfamethoxazole in the treatment of toxoplasmic encephalitis in patients with AIDS. Randomized, controlled trials of this and other agents are needed to determine the best primary prophylaxis for these patients.