Toxoplasmosis seroprevalence in rheumatoid arthritis patients: A systematic review and meta-analysis

Hosseininejad, Zahra; Sharif, Mehdi; Sarvi, Shahabeddin; Amouei, Afsaneh; Hosseini, Seyed Abdollah; Nayeri, Tooran; Anvari, Davood; Saberi, Reza; Gohardehi, Shaban; Mizani, Azadeh; Sadeghi, Mitra

doi:10.1371/journal.pntd.0006545

Cited by 38 publications

(21 citation statements)

References 41 publications

(58 reference statements)

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“…We pooled each study estimate using a random-effects model to obtain an overall summary estimate of each Echinococcus isolate genotype (G1, G2, G3, and G6), as well as the accompanying 95% confidence intervals (CIs). Heterogeneity between the results was assessed based on the Q test and the I 2 indicator [37-39]. In addition, the Egger test was used to investigate the presence of publication bias.…”

Section: Methodsmentioning

confidence: 99%

A systematic review and meta-analysis of the genetic characterization of human echinococcosis in Iran, an endemic country

et al. 2019

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Human echinococcosis is an infectious disease caused by tapeworms belonging to the species Echinococcus. This parasite has a worldwide distribution and is considered a neglected tropical disease by the World Health Organization. Due to the diversity of Echinococcus spp. hosts, as well as variation in geographical, climatic, and socio-ethnic conditions, the question of the strains or genotypes of Echinococcus spp. that are involved in human infections is important. The aim of this study was to provide a summary of the available data on genotypes of Echinococcus obtained from the Iranian population. Four international databases (PubMed, Scopus, Science Direct, and Web of Science) and 4 Persian databases (Magiran, Scientific Information Database, Iran Medex, and IranDoc) were searched for cross-sectional studies that reported the genotypes of Echinococcus spp. in human echinococcosis cases using molecular methods in Iran through July 2018. The Newcastle-Ottawa Scale was used to assess the quality of the selected studies. A total of 559 cases of human cystic echinococcosis were reported in the 21 included articles. The majority of cases belonged to genotype G1 (89.2%; 95% confidence interval [CI], 80.1 to 95.8), genotype G6 (8.2%; 95% CI, 2.8 to 15.9), and genotype G3 (2.3%; 95% CI, 1.1 to 3.9). Since genotype G1 of Echinococcus appears to be the most prevalent genotype affecting humans in Iran, disease control initiatives aimed at sheep intermediate hosts may be the most beneficial. In addition, educational programs and serological screening in individuals may help reduce the national impact of the disease.

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Section: Methodsmentioning

confidence: 99%

A systematic review and meta-analysis of the genetic characterization of human echinococcosis in Iran, an endemic country

et al. 2019

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“…T. gondii remains dormant in infected tissues and may reactivate in immunocompromised individuals, leading to potentially fatal complications [10,11]. HIV patients and hematopoietic stem cell and heart transplant recipients are more susceptible to T. gondii infection [12].…”

Section: Introductionmentioning

confidence: 99%

Serological and molecular rapid diagnostic tests for Toxoplasma infection in humans and animals

Khan

Noordin

2019

Eur J Clin Microbiol Infect Dis

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Infection by Toxoplasma gondii is prevalent worldwide. The parasite can infect a broad spectrum of vertebrate hosts, but infection of fetuses and immunocompromised patients is of particular concern. Easy-to-perform, robust, and highly sensitive and specific methods to detect Toxoplasma infection are important for the treatment and management of patients. Rapid diagnostic methods that do not sacrifice the accuracy of the assay and give reproducible results in a short time are highly desirable. In this context, rapid diagnostic tests (RDTs), especially with point-of-care (POC) features, are promising diagnostic methods in clinical microbiology laboratories, especially in areas with minimal laboratory facilities. More advanced methods using microfluidics and sensor technology will be the future trend. In this review, we discuss serological and molecular-based rapid diagnostic tests for detecting Toxoplasma infection in humans as well as animals.

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“…Due to the large gaps in knowledge about this specific subset of patients, there is a need for further data and recommendations regarding toxoplasmosis diagnosis, treatment, and prophylaxis in this population. In a recent review, 46% of RA patients studied were found to be seropositive for toxoplasma, raising concerns about the potential risk of reactivation with immunosuppressants in this population [13]. Taking into account the lack of data on this subject, there could be potential benefits from serologic testing prior to the initiation of immunosuppressive therapy such as TNF-a inhibitors.…”

Section: Studymentioning

confidence: 99%

Cerebral Toxoplasmosis in a Rheumatoid Arthritis Patient on Immunosuppressive Therapy

Hill

Wyatt

Ennis³

2020

Cureus

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Cerebral toxoplasmosis is a life-threatening infection most commonly found in immunocompromised hosts such as acquired immunodeficiency syndrome (AIDS) or transplant patients. However, it is not known to affect patients with chronic inflammatory disorders on immunosuppressive therapy. We describe the case of a 70-year-old female with rheumatoid arthritis (RA) on chronic therapy with methotrexate and infliximab, who presented to the hospital after two weeks of right-sided weakness. Imaging revealed bilateral ring-enhancing lesions in the basal ganglia (left greater than right). A diagnosis of cerebral toxoplasmosis was made on brain biopsy. Apart from the immunosuppressive therapy and owning a cat, she had no other risk factors for developing the infection. The patient's immunosuppressive medications were discontinued, and she was started on high-dose trimethoprimsulfamethoxazole (TMP-SMX). Upon literature review using PubMed, we found seven other published reports on similar cases of toxoplasmosis in RA patients on immunosuppressive therapy; however, there was a lack of recommendations for diagnosis, treatment, and prophylaxis in this patient population. With the growing use of immunosuppressive therapies in chronic inflammatory disorders, further data is needed regarding the management of toxoplasmosis in these patients. This case report is an investigation of the relationship between immunosuppressive medications in RA patients and cerebral toxoplasmosis and an exploration of the available recommendations for its management.

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Toxoplasmosis seroprevalence in rheumatoid arthritis patients: A systematic review and meta-analysis

Cited by 38 publications

References 41 publications

A systematic review and meta-analysis of the genetic characterization of human echinococcosis in Iran, an endemic country

A systematic review and meta-analysis of the genetic characterization of human echinococcosis in Iran, an endemic country

Serological and molecular rapid diagnostic tests for Toxoplasma infection in humans and animals

Cerebral Toxoplasmosis in a Rheumatoid Arthritis Patient on Immunosuppressive Therapy

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