Seroprevalence of Toxoplasma gondii IgG antibody in HIV-infected patients at the Lagos University Teaching Hospital

Abstract

BackgroundToxoplasmosis is caused by infection with a ubiquitous intracellular protozoan parasite, Toxoplasma gondii. With the advent of the HIV pandemic in Nigeria, toxoplasmic encephalitis has become one of the more frequent opportunistic infections and the most commonly implicated cause of focal brain lesions complicating the course of AIDS.ObjectivesThis study was conducted to compare the pattern of seroprevalence of T. gondii (Toxo-IgG) antibodies among HIV-infected persons presenting with neurological complications and those without.Materials and methodsPlasma specimens collected from 380 subjects were tested for Toxo- IgG antibodies by enzyme immunoassay technique and CD4 estimation by flow cytometry. Close-ended questionnaires were applied to all respondents to collect relevant data, with ethical approval from the hospital ethical committee. Plasma was obtained from two study groups comprising 300 HIV-positive respondents without neurological presentations, and 80 HIV-positive respondents with neurological complications.ResultsSeroprevalence of Toxo-IgG antibodies was 58% in the HIV-positive study group without neurological complications (of these, 79.2% were males and 38.5% were females) and 40% in the study group with neurological complications (46.2% of these were males and 28.6% were females). The overall seroprevalence of Toxo-IgG antibodies among the HIV-positive respondents (with and without neurological complications) was 54.2% (206 of 380). Seroprevalence of Toxo-IgG antibodies was lowest among the educated subjects (19% of the respondents with tertiary education) and among females in both study groups. A higher proportion of the subjects with neurological complications had CD4 cell count <100 cells/μL compared with respondents without neurological defects (39% vs 22.7%; P = 0.000), but the seroprevalence of Toxo-IgG antibodies was higher in subjects without neurological complications (45% vs 31.3%; P = 0.000).ConclusionToxoplasmosis, though an important opportunistic infection in our environment, may not account for the majority of neurological complications observed in patients with HIV infection in our center.

Seroprevalence of Toxoplasma gondii among HIV Patients in Jahrom, Southern Iran

“…Other studies [19] showed that 79.0% and 79.4% of these patients had CD4 + counts,<100 and<150 cells/μl, that are contrary to the findings in this study. Thus, CD4 + cell counts serve as a reliable indicator for possible toxoplasmosis, and also contribute significantly to protection against chronic T. gondii infections via their role as helper cells for antibodies production.…”

Cerebral Toxoplasmosis Mimicking Subacute Meningitis in HIV-Infected Patients; a Cohort Study from Indonesia

“…In the United States, toxoplasma seroprevalence varies from 3% to 30%, whereas in France 73%–90% of the population is infected [10]. Reported seroprevalence rates were varied from 13–31% in the general population, and 45–68% in HIV patients in studies from several developing countries [8], [27], [28]. In our study, 78% of patients had detectable toxoplasma IgG, but this does not reflect the seroprevalence in the general population or among unselected HIV-infected patients, as only meningitis patients were examined.…”

Fever, Hemiparesis and Hyponatraemia in a 63-year-old. HIV, another Great Masquerader?

“…The diagnosis of cerebral toxoplasmosis is supported by positive serology and neuroimaging with CT or MRI. Toxoplasma seropositivity rates in HIV patients varies in different populations from 10 to 50%, with the highest incidence occurring in Africa [5] . Toxoplasma immunoglobulin G (IgG) antibodies have a high sensitivity, with 97% of patients with cerebral toxoplasmosis having a positive result [6] .…”