Global status of Toxoplasma gondii infection and associated risk factors in people living with HIV

Abstract

Objective: Toxoplasma infection remains as the most common cause of focal brain lesions among people living with HIV (PLHIV) despite the decline in opportunistic infections with the introduction of antiretroviral treatment. This study was conducted to provide a summary of evidence about the seroprevalence of Toxoplasma gondii and prevalence of active T. gondii infection and associated risk factors among PLHIV. Design: PRISMA guidelines were followed. Scopus, PubMed, Science Direct, and EMBASE were searched from 1997 to July 2018. All peer-reviewed original research articles describing T. gondii infection among PLHIV with different diagnostic methods were included. Methods: Incoherence and heterogeneity between studies were quantified by I2 index and Cochran's Q test. Publication and population bias were assessed with funnel plots and Egger's regression asymmetry test. All statistical analyses were performed using StatsDirect. Results: A total of 111 studies from 37 countries assessing 66,139 blood samples were included in this study. The pooled prevalence of T. gondii infection among PLHIV was 3.24% by IgM and 26.22% by molecular methods using the random-effects model. Pooled seroprevalence of T. gondii by IgG was 44.22%. There was a relationship between Toxoplasma prevalence and gender, raw meat consumption, contact with cat and knowledge about toxoplasmosis. Conclusion: High Toxoplasma seroprevalence among PLHIV observed in this study emphasizes the need for implementing screening and prophylaxis tailored to the local context. Owing to the serious and significant clinical manifestations of the parasite in case of reactivation, early identification of seropositivity for initiating prophylaxis among those with a CD4 count of <200cells/mL is recommended.

Potential risk factors associated with seropositivity for Toxoplasma gondii among pregnant women and HIV infected individuals in Ethiopia: A systematic review and meta-analysis

“…The pooled prevalence of anti-Toxoplasma gondii antibodies from studies administered to the general population in Ethiopia was also found to be 74% [53]. In contrast, the present finding is higher than the global pooled prevalence estimates in pregnant women (1.1% to 33.8%) [11,13] and HIV infected individuals (3.24% to 44.2%) [1,5,14]. Significantly lower pooled seroprevalence reports in pregnant women and HIV/AIDS patients were also reported in Mexico (15.62% & 20.2%) [54], Iran (41% & 50.1%) [55,56] and Nigeria (40.3% & 31.7%) [57].…”

“…The epidemiology of Toxoplasma gondii infection in immunocompromised individuals (pregnant women and HIV infected patients) showed considerable variation between continents and countries. Recent systematic reviews have assessed and estimated the global pooled prevalence of anti-Toxoplasma gondii antibodies ranges from 1.1% to 33.8% in pregnant women [11][12][13] and 3.24% to 44.22% in HIV infected individuals [1,14]. In Africa, the pooled infection rate ranges from 1.6% to 48.7% in pregnant women [13] and 0.61% to 44.9% in HIV infected individuals [1].…”

Dehydroepiandrosterone Effect on Toxoplasma gondii: Molecular Mechanisms Associated to Parasite Death

“…T. gondii infection can induce abortion, encephalitis, and in extreme cases, death. Indeed, it is considered a major opportunistic pathogen in patients with AIDS [6,7].…”

Characteristics of T lymphocyte subsets and their apparent effect on infection in patients with chronic kidney disease

“…Chronic kidney disease (CKD) is an important contributor to morbidity and mortality in noncommunicable diseases. According to the latest data released by The Lancet, as of 2017, approximately 697.5 million people worldwide have been diagnosed with CKD 10 . In China, the prevalence rate is 10.8%, and the number of patients reached 132.3 million 10 .…”