Abstract: a feature of the HIV epidemic is currently a large number of comorbid and severe forms of the disease, with frequent involvement in the pathological process of the brain. Brain toxoplasmosis is a leader among AIDS-indicator diseases affecting the central nervous system. It runs hard, takes third place in the structure of deaths. In the early stages of HIV infection, T. gondii infection does not lead to the development of the infectious process, often ends with the formation of asymptomatic carriage. At the later stages of HIV infection, clinically expressed toxoplasmic infection develops, in the form of severe brain pathology, more often at the level of CD4 lymphocytes less than 100 CL/µl [16]. Laboratory and instrumental diagnosis of brain toxoplasmosis has a number of features. Materials and methods. The clinical,laboratory and pathomorphological study of 17 patients diagnosed with brain toxoplasmosis on the background of HIV infection, who were on inpatient treatment and died in the Novgorod infectious diseases hospital in the period 2016-2018. The final diagnosis was made taking into account clinical, laboratory, radiological and morphological studies on the classification of ICD-10 in accordance with the domestic requirements of the formulation of comorbid diagnosis. Conclusion. The structure of brain damage in deceased patients was dominated by toxoplasmosis in 20% of cases. Brain toxoplasmosis developed on the background of severe immunosuppression (CD4-lymphocyte level less than 50 CL/µl), which, in turn, was an unfavorable prognostic factor. Clinical manifestations of brain toxoplasmosis were focal symptoms (100%), cognitive impairment (100%), intoxication syndrome (100%), mild cerebral symptom (88.2%), meningeal symptom (70.6%). To verify the etiological agent, it is necessary to carry out a complex of research methods – clinical, laboratory, immunological, molecular genetic and neuroradiological.
Keywords: HIV infection, brain toxoplasmosis, clinic, radiology, pathomorphology