2018•Iranian Red Crescent Medical JournalOpen access

Toxoplasma gondii: The Prevalence and Risk Factors in HIV-Infected Patients in Fars Province, Southern Iran

Nasir Arefkha, Bahador Sarkari, Masood Afrashteh, Zahra Rezaei, M. Dehghani

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Abstract

Background: Toxoplasma gondii is a zoonotic protozoan that threatens the health of the people infected with human immunodeficiency virus (HIV). HIV-positive subjects are at risk of cerebral toxoplasmosis. Objectives: The current study was designed to find out the seroprevalence of toxoplasmosis in HIV-infected individuals in Fars province, in the South of Iran. Methods: This cross-sectional study was performed on 251 HIV-infected individuals referred to Shiraz HIV/AIDS Research Center in Fars province, Southern Iran, in 2016. Blood samples (5 mL) were collected from each individual and sera as well as buffy coat were isolated from each sample. Demographic and HIV-associated data were obtained from the patients’ medical records. Anti-Toxoplasma antibodies (both IgG and IgM) were determined by ELISA, using a commercial kit. In addition, PCR, targeting a 529 bp gene of T. gondii was performed on the patients’ buffy coats for detection of Toxoplasma DNA. Results: Anti-Toxoplasma antibodies were detected in the sera of 42 out of 251 (16.7%) HIV infected patients. Of these, 39 cases (15.5%) were seropositive only for IgG and 3 (1.2%) were positive only for IgM. Seropositive subjects mainly belonged to 40 - 49 year age group. None of the subjects were positive for Toxoplasma DNA when evaluated by the PCR. No significant associations were found between Toxoplasma seropositivity and gender, age, and CD4+ cell level (P > 0.05). Conclusions: Findings of this study demonstrated a significant rate of seroprevalence of Toxoplasma in HIV infected subjects in Fars province, Southern Iran. The seropositive cases are at risk of Toxoplasma reactivation and subsequent cerebral encephalitis. Treatment and also prevention of toxoplasmosis in HIV positive people should be considered.

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What this paper is about

Background: Toxoplasma gondii is a zoonotic protozoan that threatens the health of the people infected with human immunodeficiency virus (HIV). HIV-positive subjects are at risk of cerebral toxoplasmosis. Objectives: The current study was designed to find out the seroprevalence of toxoplasmosis in HIV-infected individuals in Fars province, in the South of Iran. Methods: This cross-sectional study was performed on 251 HIV-infected individuals referred to Shiraz HIV/AIDS Research Center in Fars province, Southern Iran, in 2016. Blood samples (5 mL) were collected from each individual and sera as well as buffy coat were isolated from each sample. Demographic and HIV-associated data were obtained from the patients’ medical records. Anti-Toxoplasma antibodies (both IgG and IgM) were determined by ELISA, using a commercial kit. In addition, PCR, targeting a 529 bp gene of T. gondii was performed on the patients’ buffy coats for detection of Toxoplasma DNA. Results: Anti-Toxoplasma antibodies were detected in the sera of 42 out of 251 (16.7%) HIV infected patients. Of these, 39 cases (15.5%) were seropositive only for IgG and 3 (1.2%) were positive only for IgM. Seropositive subjects mainly belonged to 40 - 49 year age group. None of the subjects were positive for Toxoplasma DNA when evaluated by the PCR. No significant associations were found between Toxoplasma seropositivity and gender, age, and CD4+ cell level (P > 0.05). Conclusions: Findings of this study demonstrated a significant rate of seroprevalence of Toxoplasma in HIV infected subjects in Fars province, Southern Iran. The seropositive cases are at risk of Toxoplasma reactivation and subsequent cerebral encephalitis. Treatment and also prevention of toxoplasmosis in HIV positive people should be considered.

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Available abstract

Background: Toxoplasma gondii is a zoonotic protozoan that threatens the health of the people infected with human immunodeficiency virus (HIV). HIV-positive subjects are at risk of cerebral toxoplasmosis. Objectives: The current study was designed to find out the seroprevalence of toxoplasmosis in HIV-infected individuals in Fars province, in the South of Iran. Methods: This cross-sectional study was performed on 251 HIV-infected individuals referred to Shiraz HIV/AIDS Research Center in Fars province, Southern Iran, in 2016. Blood samples (5 mL) were collected from each individual and sera as well as buffy coat were isolated from each sample. Demographic and HIV-associated data were obtained from the patients’ medical records. Anti-Toxoplasma antibodies (both IgG and IgM) were determined by ELISA, using a commercial kit. In addition, PCR, targeting a 529 bp gene of T. gondii was performed on the patients’ buffy coats for detection of Toxoplasma DNA. Results: Anti-Toxoplasma antibodies were detected in the sera of 42 out of 251 (16.7%) HIV infected patients. Of these, 39 cases (15.5%) were seropositive only for IgG and 3 (1.2%) were positive only for IgM. Seropositive subjects mainly belonged to 40 - 49 year age group. None of the subjects were positive for Toxoplasma DNA when evaluated by the PCR. No significant associations were found between Toxoplasma seropositivity and gender, age, and CD4+ cell level (P > 0.05). Conclusions: Findings of this study demonstrated a significant rate of seroprevalence of Toxoplasma in HIV infected subjects in Fars province, Southern Iran. The seropositive cases are at risk of Toxoplasma reactivation and subsequent cerebral encephalitis. Treatment and also prevention of toxoplasmosis in HIV positive people should be considered.

Key concepts: Southern Iran, Kowsar, Medicine, Toxoplasma gondii, Human immunodeficiency virus (HIV), Traditional medicine, Environmental health, Virology

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