Yes, it can. For people who do not have antibodies to Toxoplasma gondii or do have antibodies but no longer have the infection (determined using PCR), the best way to prevent toxoplasmosis is to prevent coming into contact with Toxoplasma gondii. Meats such as pork, lamb, or venison should never be eaten rare and should be cooked long enough that the internal temperature of the meat is 150°F. This is especially true for HIV+ people with CD4 cell counts less than 100.
As for cats and birds, it's always best to use rubber gloves when cleaning kitty litter boxes or removing droppings from bird cages. It's also best to clean up after these pets every day; Toxoplasma gondii is not infectious in fresh cat or bird excrement, as it takes several days for the organism's eggs to hatch while inside cat or bird feces. Testing cats and birds for Toxoplasma gondii antibodies and then keeping them inside can also reduce the risk of exposure.
Drugs used to prevent toxoplasmosis (prophylaxis) are, for the most part, the same as those used to prevent Pneumocystis pneumonia (PCP). Trimethoprim-Sulfamethoxazole (TMP-SMX; Bactrim, Septra) is the most effective combination of drugs used to prevent PCP and toxoplasmosis. And because PCP prophylaxis is generally started when a person's CD4 cell count falls below 200, he or she should be well protected against toxoplasmosis in the event his or her CD4 cell count falls below 100.
For those who cannot handle TMP-SMX, due to the allergic reactions caused by SMX, another effective option is dapsone in combination with pyrimethamine and folic acid. This triple-drug combination only needs to be taken once a week.
People who have been taking preventive treatment for toxoplasmosis and who begin a new antiretroviral regimen may be able to discontinue taking the toxoplasmosis preventive treatment once CD4 cell counts reach and remain at or above 200 for at least three months.
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