Toxoplasma gondii Infection in Immunocompromised Patients in Iran (2013-2022): A Systematic Review and Meta-Analysis

Abstract

Background: Toxoplasma gondii infection (toxoplasmosis) has the potential to cause a serious disease in immunocompromised patients and can be fatal in this population. We conducted a systematic review and meta-analysis to assess comprehensively the pooled seroprevalence of toxoplasmosis among immunocompromised patients including HIV/AIDS patients, cancer patients, and transplant recipients in Iran.
 Methods: PubMed, Web of Science, Scopus, Embase, and Google Scholar databases (international) and Scientific Information Database (SID), Magiran, IranMedex, and IranDoc databases (national) were systematically searched for all reports that possibly contained data for T. gondii prevalence in different immunocompromised populations in Iran between 2013 and 2022.
 Results: Overall, IgG seroprevalence rate of toxoplasmosis in Iranian immunocompromised patients was 45.1% (95% confidence interval (CI), 37.4–52.9). IgG seroprevalence rate of toxoplasmosis in 12 studies that included 2279 cancer patients, 19 studies that included 2565 HIV/AIDS patients and in 3 studies that included 200 transplant recipients was 43.6% (95% CI, 30.2–57.0), 45.9% (95% CI, 34.8–57.1) and 45.8% (95% CI, 32.5–59.0), respectively. Moreover, IgM seroprevalence rate in the 26 studies was 2.6% (95% CI, 1.4–3.7).
 Conclusion: Our findings represent a high seroprevalence rate of Toxoplasma IgG among immunocompromised patients. Health improvement and education toward prevention of toxoplasmosis is of great importance for these susceptible populations.

Analysis of Codon Usage Bias of Thioredoxin in Apicomplexan Protozoa

“…Apicomplexans are a class of obligate intracellular parasitic protozoa, with a large geographical distribution, which are important pathogens for humans and animals and can cause serious zoonotic diseases such as malaria, toxoplasmosis, and cryptosporidiosis [35,[39][40][41][42][43][44]79]. Besides, apicomplexans are believed to have been obtained from Protista, dividing into aconoidasida and conoidasida, including Toxoplasma gondii, Plasmodium spp., Cryptosporidium spp., Eimeria spp., Babesia spp., Theileria spp., Neospora caninum.…”

“…Multiply studies imply the invasion process of apicomplexans is mediated by a large number of invasionrelated protein molecules, including microneme proteins, rhoptry proteins, dense granule proteins, surface antigen proteins, etc [39][40][41][42][43][44]. In recent years, plenty of studies have shown that thioredoxin (Trx).…”

Formulation and evaluation of atovaquone-loaded macrophage-derived exosomes against Toxoplasma gondii : in vitro and in vivo assessment

“…T. gondii infection is generally asymptomatic in immunocompetent individuals ( 3 ). However, in immunocompromised persons, such as HIV-positive and cancer patients, as well as transplant recipients, it is a life-threatening disease primarily due to the reactivation of T. gondii cysts in the brain ( 4 ). The most widely used treatment for the management of toxoplasmosis is the combination of pyrimethamine and sulfadiazine ( 5 ).…”

Seroprevalence of Toxoplasma gondii and Neospora spp. in Horse Population of Tehran, the Capital of Iran: Insights from the First Survey Analysis

“…In addition, ingestion of raw meat containing tissue cysts with bradyzoites that develop in muscle or cerebral tissues of intermediate hosts can also lead to infection 8 . T. gondii infection does normally not affect immunocompetent hosts, although psychological disorders have been reported to be associated with T. gondii infection 9 . However, in situations such as primary infection during pregnancy the parasite can cause severe fetal malformations or even abortion.…”