Pinar ERGEN, Fatma YILMAZ-KARADAĞ, Özlem AYDIN

Seroprevalence of Toxoplasma gondii in HIV-infected patients admitted to a university hospital

Objective: Toxoplasma gondii may lead to opportunistic infections that threaten life in patients infected with HIV as opposed to the case of healthy individuals. It was aimed to investigate the seroprevalence of Toxoplasma gondii in HIV-infected patients admitted to our clinic. Methods: The files of HIV-infected patients who were admitted to our polyclinic in the period of January 1995- December 2019 were examined. From the files, information was recorded on demographic characteristics, first diagnosis date, CD4+ T lymphocyte counts at first admission, HIV RNA, T. gondii Ig G / M values and whether or not they received antibiotic prophylaxis. Findings: Although the files of 804 HIV-infected patients were examined, data on T. gondii antibodies could be accessed only in the files of 685 patients. The median values of the ages and disease durations of the patients were respectively 33 (range: 17-83) and 4 (range 0-27) years. Among the patients, 88.5% (n: 606) were male. While no patients showed T. gondii Ig M antibody positivity, 41.6% (N= 285) had T. gondii Ig G positivity. The CD4+ T lymphocyte count was under 100 in 10.0% (n: 68/678) of the patients, and among 36.8% (n: 25/68) of these patients, T. gondii Ig G was positive. While T. gondii IgG positivity was significant in the patients over the age of 40, no significant relationship was found between sex and CD4+ T lymphocyte counts. Conclusion: In patients with T. gondii Ig G positivity, the risk of toxoplasmosis reactivation increases especially when the CD4+ T lymphocyte counts fall below 200. For this reason, investigating the seroprevalence of T. gondii in patients of all ages is important to be able to assess the risks that may develop, and it should be kept in mind that seropositivity may increase by advanced age.

Keywords:

Toxoplasmosis, HIV,

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Kochanowsky JA, Koshy AA. Toxoplasmagondii. CurrBiol 2018; 28: 770-1.
Sukthana Y. Toxoplasmosis: beyond animals to humans. Trends Parasitol 2006; 22: 246.
Nissapatorn V. Toxoplasma gondii and HIV: a never-ending story. Lancet HIV 2017; 4: 146-7.
Montoya JG, Liesenfeld O. Toxoplasmosis. Lancet 2004; 363: 1965-76.
WHO. HIV/AIDS Data and statistics. (https: //www.who.int/hiv/data/en/) Erişim Tarihi 08.01.2020
Saadatnia G, Golkar M. A review on human toxoplasmosis. Scand J Infect Dis 2012; 44: 805-14.
Nissapatorn V, Lee C, Quek KF, Leong CL, Mahmud R, Abdullah KA. Toxoplasmosis in HIV/AIDS patients: a current situation. Jpn J Infect Dis 2004; 57: 160-5.
Şenoğlu S, Yeşilbağ Z, Altuntaş Aydın Ö, Kumbasar Karaosmanoğlu H, Kart Yaşar K. Toxoplasma gondii IgG Seroprevalence in Patients with HIV/AIDS. Turkiye Parazitol Derg 2018; 42: 175-9.
Aydın OA, Karaosmanoğlu HK, Korkusuz R, Nazlıcan O. Toxoplasma gondii IgG seroprevalence in HIV/AIDS patients Turkiye Parazitol Derg 2011; 35: 65-7
Rezanezhad H, Sayadi F, Shadmand E, et al. Seroprevalence of Toxoplasma gondii among HIV Patients in Jahrom, Southern Iran. Korean J Parasitol 2017; 55: 99-103.
Shen G, Wang X, Sun H, Gao Y. Seroprevalence of Toxoplasma gondii Infection among HIV/AIDS Patients in Eastern China. Korean J Parasitol 2016; 54: 93-6
O’Bryan TA, Okulicz JF, Bradley WP, Ganesan A, Merritt SE, Agan BK. Toxoplasma gondii seroprevalence: 30-year trend in an HIV-infected US military cohort. Diagn Microbiol Infect Dis 2016; 84: 34-5.
Ayi I, Sowah AO, Blay EA, Suzuki T, Ohta N, Ayeh-Kumi PF. Toxoplasma gondii infections among pregnant women, children and HIV-seropositive persons in Accra, Ghana. Trop Med Health 2016; 44: 17.
Chemoh W, Sawangjaroen N, Siripaitoon P, et al. Toxoplasma gondii-prevalence and risk factors in HIV-infected patients from songklanagarind Hospital, Southern Thailand. Front Microbiol 2015; 6: 1304.
Xavier GA, Cademartori BG, Cunha Filho NA, Farias NA. Evaluation of seroepidemiological toxoplasmosis in HIV/AIDS patients in the south of Brazil. Rev Inst Med Trop Sao Paulo 2013; 55: 25-30
Safarpour H, Cevik M, Zarean M, et al. Global status of Toxoplasma gondii infection and associated risk factors in people living with HIV. AIDS 2020; 34: 469-74. doi: 10.1097/QAD.0000000000002424. [Epub ahead of print].
Wang ZD, Wang SC, Liu HH, et al. Prevalence and burden of Toxoplasma gondii infection in HIV-infected people: a systematic review and meta-analysis. Lancet HIV 2017; 4: 177-88
Barratt JL, Harkness J, Marriott D, Ellis JT, Stark D. Importance of nonenteric protozoan infections in immunocompromised people. Clin Microbiol Rev 2010; 23: 795-836.
EACS European AIDS Clinical Society Guidelines 10.0, PART VI 105, 2019.
(https://www.eacsociety.org/guidelines/eacs-guidelines/eacs-guidelines.html) Access date: 25.11.2019.
Guidelines for the prevention and treatment of opportunistic ınfections in adults and adolescents with HIV. (https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-opportunistic-infection/322/toxoplasma-gondii) Access date: 01.10.2020.
Pozio E. Highly Active AntiRetroviral Therapy and opportunistic protozoan infections Parassitologia. 2004 ;46: 89-93.
Martin-Iguacel R, Ahlström MG, Touma M, et al. Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era. J Infect 2017; 75: 263-73.