尼日利亚阿布贾三级医院感染 HIV 的孕妇感染相关的血清学调查和危险因素。
Serological survey and risk factors associated with infection among HIV-infected pregnant women attending Abuja Tertiary Hospital, Nigeria.
机构信息
Department of Obstetrics and Gynecology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.
Department of Medical Microbiology and Parasitology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.
出版信息
Malawi Med J. 2020 Sep;32(3):160-167. doi: 10.4314/mmj.v32i3.9.
BACKGROUND
Toxoplasmosis in pregnancy could induce miscarriage, congenital anomalies in foetuses and encephalitis in HIV-infected people. Hence, there is a need to determine the prevalence of toxoplasmosis in HIV-infected pregnant women to inform clinicians about the significance of maternal toxoplasmosis in antenatal care.
AIM
This study aimed to determine the seroprevalence of Toxoplasma gondii infection, associated CD4+ T-cell profile and sociodemographic risk factors among pregnant women with or without HIV infection attending the University of Abuja Teaching Hospital, Abuja, Nigeria.
METHODS
This hospital-based cross-sectional study involved blood samples collected from 160 HIV-infected and 160 HIV-seronegative pregnant women. These samples were analysed for anti-T. gondii (IgG and IgM) and CD4+ T-cell count using ELISA and flow cytometry, respectively. Sociodemographic variables of participants were collected using structured questionnaires.
RESULTS
The overall seroprevalence of anti-T. gondii IgG and IgM was 28.8% and 3.8%, respectively. The seroprevalence of anti-T. gondii IgG and IgM was 29.4% and 4.4%, respectively, among HIV-seropositive pregnant women and 28.1% and 3.1%, respectively, among HIV-seronegative women. There was no significant association between the seroprevalence of anti-T. gondii-IgG and anti-T. gondii-IgM with age, gestational age, education level, parity or place of residence of HIV-infected pregnant women (P > 0.05). However, there was significant association between the seroprevalence of anti-T. gondii-IgG (P = 0.03) and anti-T. gondii-IgM (P = 0.01) with education level. CD4+ T-cell count varied significantly between HIV-infected and HIV-uninfected pregnant women (P = 0.035).
CONCLUSION
In this study, the seroprevalence of anti-T. gondii IgG and IgM did not differ in HIV-seropositive or HIV-seronegative pregnant women. However, women with primary T. gondii and HIV coinfection had lower CD4+ T-cell count than those with toxoplasmosis monoinfection.
背景
妊娠期间的弓形虫病可导致流产、胎儿先天畸形和 HIV 感染者的脑炎。因此，需要确定 HIV 感染孕妇中弓形虫病的流行率，以便告知临床医生围产期弓形虫病的重要性。
目的
本研究旨在确定在尼日利亚阿布贾大学教学医院就诊的 HIV 感染和未感染孕妇中，弓形虫感染的血清流行率、相关 CD4+ T 细胞特征以及社会人口学危险因素。
方法
本项基于医院的横断面研究纳入了 160 例 HIV 感染孕妇和 160 例 HIV 血清阴性孕妇的血样。使用酶联免疫吸附试验和流式细胞术分别分析这些样本的抗弓形虫（IgG 和 IgM）和 CD4+ T 细胞计数。采用结构式问卷收集参与者的社会人口学变量。
结果
总体而言，抗弓形虫 IgG 和 IgM 的血清阳性率分别为 28.8%和 3.8%。HIV 血清阳性孕妇的抗弓形虫 IgG 和 IgM 血清阳性率分别为 29.4%和 4.4%，而 HIV 血清阴性孕妇的相应血清阳性率分别为 28.1%和 3.1%。HIV 感染孕妇的抗弓形虫 IgG 和 IgM 血清阳性率与年龄、孕龄、教育水平、产次或居住地之间无显著相关性（P > 0.05）。然而，抗弓形虫 IgG 的血清阳性率（P = 0.03）和抗弓形虫 IgM 的血清阳性率（P = 0.01）与教育水平之间存在显著相关性。CD4+ T 细胞计数在 HIV 感染和未感染孕妇之间有显著差异（P = 0.035）。
结论
在本研究中，HIV 血清阳性或阴性孕妇的抗弓形虫 IgG 和 IgM 血清阳性率无差异。然而，与弓形虫病单感染相比，原发性弓形虫和 HIV 合并感染的女性 CD4+ T 细胞计数较低。
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