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Cerebral toxoplasmosis remains a common and serious complication of late-stage HIV infection. Recent controversy about the high cost of pyrimethamine, a component of two of the combination treatments (pyrimethamine + sulfadiazine [P-S] and pyrimethamine + clindamycin [P-C]) for this condition, has raised interest in comparative data on the other recommended regimen: trimethoprim–sulfamethoxazole (TMP-SMX). P-S is often considered the preferred initial therapy.
Researchers systematically reviewed the literature on all 3 recommended treatments for cerebral toxoplasmosis in HIV-infected adults, ultimately focusing on 9 studies (5 randomized trials, 3 retrospective cohort studies, and 1 prospective cohort study). Random-effects models were used …