Serological Evaluation of Toxoplasmosis and Related Risk Factors Among HIV+/AIDS Patients in Northern Iran

Acta Parasitol. 2021 Dec;66(4):1417-1423. doi: 10.1007/s11686-021-00410-7. Epub 2021 May 22.

Abstract

Purpose: Toxoplasma gondii is an important opportunistic intracellular protozoan parasite that can cause severe sequelae and even death in immunodeficient patients. This study aimed to evaluate the seroprevalence and risk factors of toxoplasmosis among HIV+/AIDS patients of the study area.

Methods: A cross-sectional study was carried out on 121 registered HIV+/AIDS patients of behavioral diseases consultation center (BDCC) in Guilan province, north of Iran. Anti-Toxoplasma IgG and IgM antibodies were measured by ELISA technique in the serum samples. IgG avidity was measured for IgG- plus IgM-positive cases. Also, the relationship between T. gondii infection and related demographic and clinical characteristics were investigated.

Results: Anti-T. gondii IgG and IgM antibodies were detected in 60.3 and 4.9% of patients, respectively. One case of acute toxoplasmosis (0.83%) was detected using an IgG avidity test. A significant correlation was observed between toxoplasmosis with age and marital status in these patients. The mean CD4+count of HIV+/AIDS patients was 549 ± 27 cells/µl. Viral load in 69.7% of the HIV patients was less than1000 copies/ml.

Conclusion: None of the T. gondii IgM-positive HIV patients received anti-Toxoplasma prophylaxis. This finding highlights the importance of T. gondii infection surveillance in HIV patients. Regarding the high prevalence of toxoplasmosis in the study population, educational efforts are recommended to prevent reactivation or acquiring primary infection and developing severe cases of toxoplasmosis in immunocompromised HIV+/AIDS patients.

Keywords: HIV; Iran; Seroprevalence; Toxoplasma gondii.

MeSH terms

  • Antibodies, Protozoan
  • Cross-Sectional Studies
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Humans
  • Immunoglobulin G
  • Immunoglobulin M
  • Iran / epidemiology
  • Risk Factors
  • Seroepidemiologic Studies
  • Toxoplasma*
  • Toxoplasmosis* / complications
  • Toxoplasmosis* / epidemiology

Substances

  • Antibodies, Protozoan
  • Immunoglobulin G
  • Immunoglobulin M