Department of Microbiology, Apollo Hospitals, Navi Mumbai, Maharashtra, India.
Department of Microbiology, Seth G.S. Medical College & K.E.M. Hospital, Mumbai, Maharashtra, India.
Indian J Med Res. 2020 Nov;152(5):515-518. doi: 10.4103/ijmr.IJMR_110_19.
BACKGROUND & OBJECTIVES: Immunocompromised individuals mainly HIV infected patients are at a great risk for developing toxoplasmosis. The presence of toxoplasmosis among HIV-infected patients directly correlates with the prevalence of anti- Toxoplasma gondii antibodies and the degree of immunosuppression (measured by CD4 counts). The data regarding the seroprevalence of toxoplasmosis in HIV-infected patients are scarce in India. Therefore, this study was initiated to find out the seroprevalence of toxoplasmosis in treatment-naïve HIV seropositive patients and to determine its association with CD4 counts, if any.
Four hundred newly diagnosed antiretroviral therapy (ART) naïve adult HIV positive patients coming for CD4 count estimation were tested for the presence of anti- Toxoplasma IgG antibodies. Risk factors for acquisition of toxoplasmosis as well as the age, gender and CD4 counts of the patient were noted down.
Toxoplasma IgG was positive in 292 (73%) patients, and the positivity was not related to their CD4 counts. The proportion of anti- Toxoplasma IgG positivity showed no significant association with age, gender and risk factors of the patients.
INTERPRETATION & CONCLUSIONS: In the absence of any specific vaccine or prophylaxis for toxoplasmosis, it is pertinent to screen all HIV-positive patients for Toxoplasma IgG at diagnosis, irrespective of their CD4 counts, and sensitize them about the means to prevent either acquisition or activation of infection to avert the development of toxoplasmic encephalitis.
免疫功能低下者,主要是 HIV 感染者,患弓形虫病的风险很高。HIV 感染者中弓形虫病的存在与抗弓形虫抗体的流行以及免疫抑制程度(通过 CD4 计数测量)直接相关。在印度,关于 HIV 感染者中弓形虫病的血清流行率的数据很少。因此,本研究旨在确定初治 HIV 血清阳性患者中弓形虫病的血清流行率,并确定其与 CD4 计数的任何关联(如果有)。
对 400 名新诊断的抗逆转录病毒治疗(ART)初治成年 HIV 阳性患者进行了抗弓形虫 IgG 抗体检测。记录了获得弓形虫病的危险因素以及患者的年龄、性别和 CD4 计数。
292 名(73%)患者的弓形虫 IgG 呈阳性,且其阳性与 CD4 计数无关。抗弓形虫 IgG 阳性的比例与患者的年龄、性别和危险因素无显著关联。
在没有针对弓形虫病的特定疫苗或预防措施的情况下,在诊断时对所有 HIV 阳性患者进行弓形虫 IgG 筛查,无论其 CD4 计数如何,都很重要,并使他们了解预防感染获得或激活的方法,以避免弓形虫脑炎的发生。