Congenital toxoplasmosis: What is the evidence for chemoprophylaxis to prevent fetal infection?
Antiprotozoal Agents
/ therapeutic use
Asymptomatic Infections
Drug Therapy, Combination
Female
Global Health
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical
/ prevention & control
Patient Safety
Pregnancy
Pregnancy Complications, Infectious
/ diagnosis
Prenatal Care
/ methods
Toxoplasmosis, Congenital
/ diagnosis
Journal
Prenatal diagnosis
ISSN: 1097-0223
Titre abrégé: Prenat Diagn
Pays: England
ID NLM: 8106540
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
17
02
2020
revised:
02
05
2020
accepted:
23
05
2020
pubmed:
27
5
2020
medline:
26
10
2021
entrez:
27
5
2020
Statut:
ppublish
Résumé
Although prenatal diagnosis and prenatal and neonatal therapy of congenital toxoplasmosis are available, there is controversy concerning the effectiveness of prophylaxis to prevent placental transmission. Experimental, parasitological, and clinical data suggest a "window of opportunity" following maternal infection. Among medications active against Toxoplasma gondii, mainly spiramycin (Spy) and pyrimethamine + sulfonamide combinations (P-S) have been evaluated. Results from observational studies suffered treatment bias, since prescriptions differed according to the gestational age at seroconversion, which is the major risk factor for transmission, and many lacked precise timing. Some large retrospective studies found no difference in transmission according to prophylactic treatment, but transmission was lower when treatment started promptly after maternal seroconversion. A few recent studies adjusting for timing of infection observed lower transmission in case of P-S than other or no prophylaxis. In the only randomized controlled trial, transmission was lower with P-S than S (18.5% vs 30%, P = .147); this association was strengthened when the treatment was started within 3 weeks of seroconversion, and the incidence of fetal cerebral ultrasound signs was significantly reduced in the P-S group. Rapid initiation of prophylactic therapy following maternal infection, which is usually asymptomatic, requires systematic screening for maternal seroconversion during pregnancy.
Substances chimiques
Antiprotozoal Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1693-1702Informations de copyright
© 2020 John Wiley & Sons, Ltd.
Références
Thiebaut R, Leproust S, Chene G, Gilbert R. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients' data. Lancet. 2007;369(9556):115-122.
Peyron F, Mc Leod R, Ajzenberg D, et al. Congenital toxoplasmosis in France and the United States: one parasite, two diverging approaches. PLoS Negl Trop Dis. 2017;11(2):e0005222.
Torgerson PR, Mastroiacovo P. The global burden of congenital toxoplasmosis: a systematic review. Bull World Health Organ. 2013;91(7):501-508.
El Bissati K, Levigne P, Lykins J, et al. Global initiative for congenital toxoplasmosis: an observational and international comparative clinical analysis. Emerg Microb Infect. 2018;7(1):165.
Maldonado YA, Read JS. Diagnosis, treatment, and prevention of congenital toxoplasmosis in the United States. Pediatrics. 2017;139(2).e1-e51.
Nogareda F, Le Strat Y, Villena I, De Valk H, Goulet V. Incidence and prevalence of Toxoplasma gondii infection in women in France, 1980-2020: model-based estimation. Epidemiol Infect. 2014;142(8):1661-1670.
Montoya JG, Liesenfeld O. Toxoplasmosis. Lancet. 2004;363(9425):1965-1976.
Di Mario S, Basevi V, Gagliotti C, et al. Prenatal education for congenital toxoplasmosis. Cochrane Database Syst Rev. 2015;(10):Cd006171.https://doi.org/10.1002/14651858.CD006171.pub4.
Prusa AR, Kasper DC, Sawers L, Walter E, Hayde M, Stillwaggon E. Congenital toxoplasmosis in Austria: prenatal screening for prevention is cost-saving. PLoS Negl Trop Dis. 2017;11(7):e0005648.
Wallon M, Peyron F, Cornu C, et al. Congenital toxoplasma infection: monthly prenatal screening decreases transmission rate and improves clinical outcome at age 3 years. Clin Infect Dis. 2013;56(9):1223-1231.
Mandelbrot L, Kieffer F, Sitta R, et al. Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial. Am J Obstet Gynecol. 2018;219(4):386.e1-386.e9.
Gilbert R, Gras L. European Multicentre Study on Congenital T. Effect of timing and type of treatment on the risk of mother to child transmission of Toxoplasma gondii. BJOG. 2003;110(2):112-120.
Gratzl R, Sodeck G, Platzer P, et al. Treatment of toxoplasmosis in pregnancy: concentrations of spiramycin and neospiramycin in maternal serum and amniotic fluid. Europ J Clin Microbiol Infect Dis. 2002;21(1):12-16.
Dunay IR, Gajurel K, Dhakal R, Liesenfeld O, Montoya JG. Treatment of toxoplasmosis: historical perspective, animal models, and current clinical practice. Clin Microbiol Rev. 2018;31(4).1-33.
Valentini P, Buonsenso D, Barone G, et al. Spiramycin/cotrimoxazole versus pyrimethamine/sulfonamide and spiramycin alone for the treatment of toxoplasmosis in pregnancy. J Perinatol. 2015;35(2):90-94.
Valentini P, Annunziata ML, Angelone DF, et al. Role of spiramycin/cotrimoxazole association in the mother-to-child transmission of toxoplasmosis infection in pregnancy. Europ J Clin Microbiol Infect Dis. 2009;28(3):297-300.
Derouin F. Anti-toxoplasmosis drugs. Curr Opin Investig Drugs. 2001;2(10):1368-1374.
Connolly MP, Haitsma G, Hernandez AV, Vidal JE. Systematic review and meta-analysis of secondary prophylaxis for prevention of HIV-related toxoplasmic encephalitis relapse using trimethoprim-sulfamethoxazole. Pathog Glob Health. 2017;111(6):327-331.
Hernandez AV, Thota P, Pellegrino D, et al. A systematic review and meta-analysis of the relative efficacy and safety of treatment regimens for HIV-associated cerebral toxoplasmosis: is trimethoprim-sulfamethoxazole a real option? HIV Med. 2017;18(2):115-124.
Wei HX, Wei SS, Lindsay DS, Peng HJ. A systematic review and meta-analysis of the efficacy of anti-Toxoplasma gondii medicines in humans. PLoS One. 2015;10(9):e0138204.
Zhang Y, Lin X, Lu F. Current treatment of ocular toxoplasmosis in immunocompetent patients: a network meta-analysis. Acta Trop. 2018;185:52-62.
Schoondermark-van de Ven EM, Melchers WJ, Galama JM, Meuwissen JH, Eskes TK. Prenatal diagnosis and treatment of congenital Toxoplasma gondii infections: an experimental study in rhesus monkeys. Eur J Obstet Gynecol Reprod Biol. 1997;74(2):183-188.
Kieffer F, Wallon M, Garcia P, Thulliez P, Peyron F, Franck J. Risk factors for retinochoroiditis during the first 2 years of life in infants with treated congenital toxoplasmosis. Pediatr Infect Dis J. 2008;27(1):27-32.
Foulon W, Villena I, Stray-Pedersen B, et al. Treatment of toxoplasmosis during pregnancy: a multicenter study of impact on fetal transmission and children's sequelae at age 1 year. Am J Obstet Gynecol. 1999;180(2 Pt 1):410-415.
Hohlfeld P, Daffos F, Thulliez P, et al. Fetal toxoplasmosis: outcome of pregnancy and infant follow-up after in utero treatment. J Pediatr. 1989;115(5 Pt 1):765-769.
Avelino MM, Amaral WN, Rodrigues IM, et al. Congenital toxoplasmosis and prenatal care state programs. BMC Infect Dis. 2014;14:33.
Cortina-Borja M, Tan HK, Wallon M, et al. Prenatal treatment for serious neurological sequelae of congenital toxoplasmosis: an observational prospective cohort study. PLoS Med. 2010;7(10).1-11.
Olariu TR, Press C, Talucod J, Olson K, Montoya JG. Congenital toxoplasmosis in the United States: clinical and serologic findings in infants born to mothers treated during pregnancy. Parasite. 2019;26:13.
Mandelbrot L. Prevention of mother-to-child transmission of toxoplasmosis: perspectives. Gynecol Obstet Fertil. 2012;40(10):591-598.
Robert-Gangneux F, Murat JB, Fricker-Hidalgo H, Brenier-Pinchart MP, Gangneux JP, Pelloux H. The placenta: a main role in congenital toxoplasmosis? Trends Parasitol. 2011;27(12):530-536.
Abbasi M, Kowalewska-Grochowska K, Bahar MA, Kilani RT, Winkler-Lowen B, Guilbert LJ. Infection of placental trophoblasts by Toxoplasma gondii. J Infect Dis. 2003;188(4):608-616.
Harker KS, Ueno N, Lodoen MB. Toxoplasma gondii dissemination: a parasite's journey through the infected host. Parasite Immunol. 2015;37(3):141-149.
Arora N, Sadovsky Y, Dermody TS, Coyne CB. Microbial vertical transmission during human pregnancy. Cell Host Microbe. 2017;21(5):561-567.
Couvreur J, Desmonts G, Thulliez P. Prophylaxis of congenital toxoplasmosis. Effects of spiramycin on placental infection. J Antimicrob Chemother. 1988;22(Suppl B):193-200.
Bessieres MH, Berrebi A, Rolland M, et al. Neonatal screening for congenital toxoplasmosis in a cohort of 165 women infected during pregnancy and influence of in utero treatment on the results of neonatal tests. Eur J Obstet Gynecol Reprod Biol. 2001;94(1):37-45.
Fricker-Hidalgo H, Brenier-Pinchart MP, Schaal JP, Equy V, Bost-Bru C, Pelloux H. Value of Toxoplasma gondii detection in one hundred thirty-three placentas for the diagnosis of congenital toxoplasmosis. Pediatr Infect Dis J. 2007;26(9):845-846.
Thiebaut R, Leroy V, Alioum A, et al. Biases in observational studies of the effect of prenatal treatment for congenital toxoplasmosis. Eur J Obstet Gynecol Reprod Biol. 2006;124(1):3-9.
Desmonts G, Couvreur J. Congenital toxoplasmosis. A prospective study of 378 pregnancies. N Engl J Med. 1974;290(20):1110-1116.
Peyron F, Wallon M, Liou C, Garner P. Treatments for toxoplasmosis in pregnancy. Cochrane Database Syst Rev. 2000;2:CD001684.
Desmonts G, Couvreur J. Congenital toxoplasmosis. Prospective study of the outcome of pregnancy in 542 women with toxoplasmosis acquired during pregnancy. Ann Pediatr (Paris). 1984;31(10):805-809.
Douche C, Benabdesselam A, Mokhtari F, Le Mer Y. Value of prevention of congenital toxoplasmosis. J Fr Ophtalmol. 1996;19(5):330-334.
Excler JLPM, Maisonneuve H, Pujol E, Garin JP. Depistage de la toxoplasmose acquise chez la femme enceinte et de la toxoplasmose congenitale chez le nouveau-ne. Lyon Med. 1985;253:33-38.
Roux C, Desmonts G, Gaulier M, Mulliez N, Hery D. Prevention of congenital toxoplasmosis. Results at the maternity department of the Hopital Saint-Antoine in 1972. J Gynecol Obstet Biol Reprod (Paris). 1975;4(4):557-569.
Lambotte R. Congenital toxoplasmosis. Evaluation of the benefit of prenatal therapy. J Gynecol Obstet Biol Reprod (Paris). 1976;5(2):265-269.
Horion M, Thoumsin H, Senterre J, Lambotte R. 20 years of screening for toxoplasmosis in pregnant women. The Liege experience in 20,000 pregnancies. Rev Med Liege. 1990;45(10):492-497.
Kraubig H. Praventive Behandlung der konnatalen Toxoplasmose. In: HKH K, ed. Toxoplasmose Praktische Fragen une Ergebnisse. Stuttgart, Germany: Georg Thieme Verlag; 1966.
Knerer B, Hayde M, Gratzl R, Strobl W, Pollak A. Direct detection of Toxoplasma gondii with polymerase chain reaction in diagnosis of fetal toxoplasma infection. Wien Klin Wochenschr. 1995;107(4):137-140.
Wallon MPF, Lebech M, Petersen E, Gilbert R, Dunn D. Prenatal treatment and the risk of congenital toxoplasmosis: preliminary findings from two cohort studies. Pediatr Res. 1997;42(3):.400-400.
Gilbert R, Dunn D, Wallon M, et al. Ecological comparison of the risks of mother-to-child transmission and clinical manifestations of congenital toxoplasmosis according to prenatal treatment protocol. Epidemiol Infect. 2001;127(1):113-120.
Gilbert RE, Gras L, Wallon M, Peyron F, Ades AE, Dunn DT. Effect of prenatal treatment on mother to child transmission of Toxoplasma gondii: retrospective cohort study of 554 mother-child pairs in Lyon, France. Int J Epidemiol. 2001;30(6):1303-1308.
Gras L, Gilbert RE, Ades AE, Dunn DT. Effect of prenatal treatment on the risk of intracranial and ocular lesions in children with congenital toxoplasmosis. Int J Epidemiol. 2001;30(6):1309-1313.
Gras L, Wallon M, Pollak A, et al. Association between prenatal treatment and clinical manifestations of congenital toxoplasmosis in infancy: a cohort study in 13 European centres. Acta Paediatr. 2005;94(12):1721-1731.
Freeman K, Tan HK, Prusa A, et al. Predictors of retinochoroiditis in children with congenital toxoplasmosis: European, prospective cohort study. Pediatrics. 2008;121(5):e1215-e1222.
Gilbert RE, Freeman K, Lago EG, et al. Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe. PLoS Negl Trop Dis. 2008;2(8):e277.
Campello Porto L, Duarte EC. Association between the risk of congenital toxoplasmosis and the classification of toxoplasmosis in pregnant women and prenatal treatment in Brazil, 1994-2009. Int J Infect Dis. 2012;16(7):e480-e486.
Donadono V, Saccone G, Maruotti GM, et al. Incidence of toxoplasmosis in pregnancy in Campania: a population-based study on screening, treatment, and outcome. Eur J Obstet Gynecol Reprod Biol. 2019;240:316-321.
Tomasoni LR, Meroni V, Bonfanti C, et al. Multidisciplinary approach to congenital Toxoplasma infection: an Italian nationwide survey. New Microbiol. 2014;37(3):347-354.
Todros T, Oliveri MG, Verdiglione P, et al. Prenatal diagnosis and treatment of congenital toxoplasmosis: a program of regional surveillance. Minerva Ginecol. 2000;52(12 Suppl 1):123-134.
Prusa AR, Kasper DC, Pollak A, Gleiss A, Waldhoer T, Hayde M. The Austrian Toxoplasmosis Register, 1992-2008. Clin Infect Dis. 2015;60(2):e4-e10.
Hotop A, Hlobil H, Gross U. Efficacy of rapid treatment initiation following primary Toxoplasma gondii infection during pregnancy. Clin Infect Dis. 2012;54(11):1545-1552.
Szenasi Z, Ozsvar Z, Nagy E, et al. Prevention of congenital toxoplasmosis in Szeged. Hungary Int J Epidemiol. 1997;26(2):428-435.
Bischoff AR, Friedrich L, Cattan JM, Uberti FA. Incidence of symptomatic congenital toxoplasmosis during ten years in a Brazilian Hospital. Pediatr Infect Dis J. 2016;35(12):1313-1316.
Ricci M, Pentimalli H, Thaller R, Rava L, Di Ciommo V. Screening and prevention of congenital toxoplasmosis: an effectiveness study in a population with a high infection rate. J Matern Fetal Neonatal Med. 2003;14(6):398-403.
Logar J, Petrovec M, Novak-Antolic Z, et al. Prevention of congenital toxoplasmosis in Slovenia by serological screening of pregnant women. Scand J Infect Dis. 2002;34(3):201-204.
Galanakis E, Manoura A, Antoniou M, et al. Outcome of toxoplasmosis acquired during pregnancy following treatment in both pregnancy and early infancy. Fetal Diagn Ther. 2007;22(6):444-448.
Avci ME, Arslan F, Ciftci S, et al. Role of spiramycin in prevention of fetal toxoplasmosis. J Matern Fetal Neonatal Med. 2016;29(13):2073-2076.
Montoya JG. Systematic screening and treatment of toxoplasmosis during pregnancy: is the glass half full or half empty? Am J Obstet Gynecol. 2018;219(4):315-319.
Peyron F, L'Ollivier C, Mandelbrot L, et al. Maternal and congenital toxoplasmosis: diagnosis and treatment recommendations of a French Multidisciplinary Working Group. Pathogens. 2019;8(1).1-15.
Meroni V, Genco F, Tinelli C, et al. Spiramycin treatment of Toxoplasma gondii infection in pregnant women impairs the production and the avidity maturation of T. gondii-specific immunoglobulin G antibodies. Clin Vaccine Immunol. 2009;16(10):1517-1520.
Wallon M, Franck J, Thulliez P, et al. Accuracy of real-time polymerase chain reaction for Toxoplasma gondii in amniotic fluid. Obstet Gynecol. 2010;115(4):727-733.
de Oliveira Azevedo CT, do Brasil PE, Guida L, Lopes Moreira ME. Performance of polymerase chain reaction analysis of the amniotic fluid of pregnant women for diagnosis of congenital toxoplasmosis: a systematic review and meta-analysis. PLoS One. 2016;11(4):e0149938.
Sterkers Y, Pratlong F, Albaba S, et al. Novel interpretation of molecular diagnosis of congenital toxoplasmosis according to gestational age at the time of maternal infection. J Clin Microbiol. 2012;50(12):3944-3951.
Bessieres MH, Berrebi A, Cassaing S, et al. Diagnosis of congenital toxoplasmosis: prenatal and neonatal evaluation of methods used in Toulouse University Hospital and incidence of congenital toxoplasmosis. Memorias Do Instituto Oswaldo Cruz. 2009;104(2):389-392.
Ford N, Shubber Z, Jao J, Abrams EJ, Frigati L, Mofenson L. Safety of cotrimoxazole in pregnancy: a systematic review and meta-analysis. J Acquir Immune Defic Syndr. 2014;66(5):512-521.
Kajubi R, Ochieng T, Kakuru A, et al. Monthly sulfadoxine-pyrimethamine versus dihydroartemisinin-piperaquine for intermittent preventive treatment of malaria in pregnancy: a double-blind, randomised, controlled, superiority trial. Lancet. 2019;393(10179):1428-1439.
van der Ven AJ, Schoondermark van de Ven EM, Camps W, et al. Anti-toxoplasma effect of pyrimethamine, trimethoprim and sulphonamides alone and in combination: implications for therapy. J Antimicrob Chemother. 1996;38(1):75-80.
Ajzenberg D. High burden of congenital toxoplasmosis in the United States: the strain hypothesis? Clin Infect Dis. 2012;54(11):1606-1607.
Ajzenberg D, Cogne N, Paris L, et al. Genotype of 86 Toxoplasma gondii isolates associated with human congenital toxoplasmosis, and correlation with clinical findings. J Infect Dis. 2002;186(5):684-689.
Gomez-Marin JE, De la Torre A, Angel-Muller E, et al. First Colombian multicentric newborn screening for congenital toxoplasmosis. PLoS Negl Trop Dis. 2011;5(5):e1195.
HAS HAdS. (n.d.). Recommandation en santé publique: Surveillance serologie toxoplasmose et rubéole durant la grossesse.
Rudin C, Hirsch HH, Spaelti R, Schaedelin S, Klimkait T. Decline of seroprevalence and incidence of congenital toxoplasmosis despite changing prevention policy-three decades of cord-blood screening in North-Western Switzerland. Pediatr Infect Dis J. 2018;37(11):1087-1092.
McLeod R, Boyer K, Karrison T, et al. Outcome of treatment for congenital toxoplasmosis, 1981-2004: the National Collaborative Chicago-Based, Congenital Toxoplasmosis Study. Clin Infect Dis. 2006;42(10):1383-1394.
Stillwaggon E, Carrier CS, Sautter M, McLeod R. Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. PLoS Negl Trop Dis. 2011;5(9):e1333.
Lykins J, Li X, Levigne P, et al. Rapid, inexpensive, fingerstick, whole-blood, sensitive, specific, point-of-care test for anti-toxoplasma antibodies. PLoS Neglect Trop Dis. 2018;12(8):e0006536-e.