Login Register Cart 0
Generic placeholder image

Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Systematic Review Article

Prevalence of Toxoplasma gondii in HIV-Infected Individuals in Iran: A Systematic Review and Meta-Analysis

Author(s): Pegah Shakib, Masoud Behzadifar, Hossein Mahmoudvand, Sara Larki, Hamed Kalani, Masoomeh Zivdari, Omid Mardanshah and Kourosh Cheraghipour*

Volume 21, Issue 4, 2023

Published on: 17 October, 2023

Page: [221 - 231] Pages: 11

DOI: 10.2174/011570162X244384230920033134

Price: $65

Abstract

Introduction: Toxoplasma gondii is an obligate intracellular protozoan that can infect almost all warm-blooded animals, including humans. Patients with co-infection with toxoplasmosis and HIV have a 30-40% risk of developing toxoplasmosis encephalitis. This study aimed to describe the epidemiology and burden of Toxoplasma gondii in HIV-infected individuals in Iran.

Methods: We searched the five English databases (Science Direct, PubMed, Scopus, Ovid, Embase, and Cochrane) and four Persian databases (Scientific Information Database (SID), Iran Medex, Iran Doc, and Magiran) with the terms of (Toxoplasma gondii OR “toxoplasmosis”) AND (HIV OR “AIDS” OR immunodeficiency OR acquired immune deficiency syndrome) AND (Seroprevalence) AND (Seroepidemiologic Studies) AND (Elisa OR IgG) AND (PCR) AND (Iran) by two authors up to Feb 2021. Studies were included if they investigated people with HIV infection and presented data that allowed us to establish the prevalence of Toxoplasma gondii infection in Iran.

Results: According to the inclusion/exclusion criteria, 15 studies were selected. A total number of 2275 HIV-infected individuals were tested and evaluated for toxoplasmosis from 2005 up to 2018 in different regions of Iran. The weighted overall prevalence of toxoplasmosis in HIV-infected individuals with Elisa was obtained using a random-effects model, which was estimated at 47% (95% CI = 31% – 62%). Also, the Weighted overall prevalence of toxoplasmosis in HIV-infected individuals with PCR was obtained using a random-effects model, which was estimated at 7% (95% CI = 3% – 12%).

Conclusion: According to the results of this study, it can be clearly understood that a large population of HIV patients living in Iran have toxoplasmosis. Therefore, due to the high susceptibility of these groups to toxoplasmosis, healthcare professionals must consider measures such as training in the ways of transmission and prevention of the infection to this high-risk group in order to reduce the risk of infection.

Next »
Graphical Abstract

[1]
Montoya J, Liesenfeld O. Toxoplasmosis. Lancet 2004; 363: 1965-76.
[2]
Saadatnia G, Golkar M. A review on human toxoplasmosis. Scand J Infect Dis 2012; 44(11): 805-14.
[http://dx.doi.org/10.3109/00365548.2012.693197] [PMID: 22831461]
[3]
Gholami M, Mohammadi A, Fallah N. Seroprevalence of Toxoplasmosis in blood donors of Hamadan transfusion center in 2013. yafte 2015; 17(2): 113-22.
[4]
Hassanzadeh M, Rasti S, Hooshyar H, Momen-Heravi M, Soliemani A, Mousavi G. Seroepidemiology of Toxoplasma gondii infection in immunodeficiency patients in Kashan and Qom during 2014-2015. Feyz J Kashan Uni Med Sci 2017; 21(5): 483-9.
[5]
Ruiz-Fons F, Vicente J, Vidal D, et al. Seroprevalence of six reproductive pathogens in European wild boar (Sus scrofa) from Spain: The effect on wild boar female reproductive performance. Theriogenology 2006; 65(4): 731-43.
[http://dx.doi.org/10.1016/j.theriogenology.2005.07.001] [PMID: 16076482]
[6]
Xavier GA, Cademartori BG, Cunha Filho NA, Farias NAR. Evaluation of seroepidemiological toxoplasmosis in HIV/AIDS patients in the south of Brazil. Rev Inst Med Trop São Paulo 2013; 55(1): 25-30.
[http://dx.doi.org/10.1590/S0036-46652013000100005] [PMID: 23328722]
[7]
Yazar S, Yaman O, Eser B, Altuntaş F, Kurnaz F, Şahin I. Investigation of anti-Toxoplasma gondii antibodies in patients with neoplasia. J Med Microbiol 2004; 53(12): 1183-6.
[http://dx.doi.org/10.1099/jmm.0.45587-0] [PMID: 15585495]
[8]
Ghasemian M, Maraghi S, Saki J, Pedram M. Determination of antibodies (IgG, IgM) against Toxoplasma gondii in patients with cancer. Iran J Parasitol 2007; 2(4): 1-6.
[9]
Rostami A, Keshavarz H, Shojaee S, Mohebali M, Meamar AR. Frequency of toxoplasma gondii in HIV positive patients from west of iran by ELISA and PCR. Iran J Parasitol 2014; 9(4): 474-81.
[PMID: 25759728]
[10]
Saki J, Khademvatan S, Soltani S, Shahbazian H. Detection of toxoplasmosis in patients with end-stage renal disease by enzyme-linked immunosorbent assay and polymerase chain reaction methods. Parasitol Res 2013; 112(1): 163-8.
[http://dx.doi.org/10.1007/s00436-012-3120-6] [PMID: 22992896]
[11]
Soltani S, Khademvatan S, Saki J, Shahbazian H. Detection of toxoplasmosis in renal transplant recipients by ELISA and PCR methods in Ahvaz, south-west of Iran. Jundishapur J Microbiol 2013; 6(9)
[http://dx.doi.org/10.5812/jjm.7642]
[12]
WHO. Guide to Monitoring and Evaluation for Collaborative TB/HIV Activities-2015 Update. World Health Organization. 2015.
[13]
Savsek L, Opaskar TR. Cerebral toxoplasmosis in a diffuse large B cell lymphoma patient. Radiol Oncol 2016; 50(1): 87-93.
[http://dx.doi.org/10.1515/raon-2014-0042] [PMID: 27069454]
[14]
Agrawal S, Singh V, Ingale S, Jain A. Toxoplasmosis of spinal cord in acquired immunodeficiency syndrome patient presenting as paraparesis: A rare entity. J Glob Infect Dis 2014; 6(4): 178-81.
[http://dx.doi.org/10.4103/0974-777X.145248] [PMID: 25538456]
[15]
Pott H Jr, Castelo A. Isolated cerebellar toxoplasmosis as a complication of HIV infection. Int J STD AIDS 2013; 24(1): 70-2.
[http://dx.doi.org/10.1258/ijsa.2012.012189] [PMID: 23512507]
[16]
Lu N, Liu C, Wang J, Ding Y, Ai Q. Toxoplasmosis complicating lung cancer: A case report. Int Med Case Rep J 2015; 8: 37-40.
[http://dx.doi.org/10.2147/IMCRJ.S76488] [PMID: 25653562]
[17]
Barratt JLN, Harkness J, Marriott D, Ellis JT, Stark D. Importance of nonenteric protozoan infections in immunocompromised people. Clin Microbiol Rev 2010; 23(4): 795-836.
[http://dx.doi.org/10.1128/CMR.00001-10] [PMID: 20930074]
[18]
Grant IH, Gold JWM, Rosenblum M, Niedzwiecki D, Armstrong D. Toxoplasma gondii serology in HIV-infected patients. AIDS 1990; 4(6): 519-22.
[http://dx.doi.org/10.1097/00002030-199006000-00004] [PMID: 2386617]
[19]
Mamidi A, DeSimone JA, Pomerantz RJ. Central nervous system infections in individuals with HIV-1 infection. J Neurovirol 2002; 8(3): 158-67.
[http://dx.doi.org/10.1080/13550280290049723] [PMID: 12053271]
[20]
Welker Y, Molina JM, Poirot C, et al. Interaction between human immunodeficiency virus and Toxoplasma gondii replication in dually infected monocytoid cells. Infect Immun 1993; 61(4): 1596-8.
[http://dx.doi.org/10.1128/iai.61.4.1596-1598.1993] [PMID: 8454371]
[21]
Bala S, Englund G, Kovacs J, Wahl L, Martin M, Sher A, et al. Toxoplasma gondii soluble products induce cytokine secretion by macrophages and potentiate in vitro replication of a monotropic strain of HIV. J Eukaryotic Microbiol 1994; 41(5): 7S-S.
[22]
Colombo FA, Vidal JE, Oliveira ACP, et al. Diagnosis of cerebral toxoplasmosis in AIDS patients in Brazil: Importance of molecular and immunological methods using peripheral blood samples. J Clin Microbiol 2005; 43(10): 5044-7.
[http://dx.doi.org/10.1128/JCM.43.10.5044-5047.2005] [PMID: 16207959]
[23]
Daryani A, Sharif M, Meigouni M. Seroprevalence of IgG and IgM anti-Toxoplasma antibodies in HIV/AIDS patients, northern Iran. Asian Pac J Trop Med 2011; 4(4): 271-4.
[http://dx.doi.org/10.1016/S1995-7645(11)60084-9] [PMID: 21771468]
[24]
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Int J Surg 2010; 8(5): 336-41.
[http://dx.doi.org/10.1016/j.ijsu.2010.02.007] [PMID: 20171303]
[25]
Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid-Based Healthc 2015; 13(3): 147-53.
[http://dx.doi.org/10.1097/XEB.0000000000000054] [PMID: 26317388]
[26]
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7(3): 177-88.
[http://dx.doi.org/10.1016/0197-2456(86)90046-2] [PMID: 3802833]
[27]
Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327(7414): 557-60.
[http://dx.doi.org/10.1136/bmj.327.7414.557] [PMID: 12958120]
[28]
Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315(7109): 629-34.
[http://dx.doi.org/10.1136/bmj.315.7109.629] [PMID: 9310563]
[29]
Mohraz M, Mehrkhani F, Jam S, et al. Seroprevalence of toxoplasmosis in HIV(+)/AIDS patients in Iran. Acta Med Iran 2011; 49(4): 213-8.
[PMID: 21713730]
[30]
Rahimi MT, Mahdavi SA, Javadian B, et al. High seroprevalence of toxoplasma gondii antibody in HIV/AIDS individuals from north of Iran. Iran J Parasitol 2015; 10(4): 584-9.
[PMID: 26811725]
[31]
Bavand A, Aghakhani A, Mohraz M, et al. Prevalence of toxoplasma gondii antibodies and DNA in iranian HIV patients. Iran J Pathol 2018; 14(1): 68-75.
[http://dx.doi.org/10.30699/ijp.14.1.68] [PMID: 31531103]
[32]
Rezanezhad H, Sayadi F, Shadmand E, et al. Seroprevalence of Toxoplasma gondii among HIV patients in Jahrom, Southern Iran. Korean J Parasitol 2017; 55(1): 99-103.
[http://dx.doi.org/10.3347/kjp.2017.55.1.99] [PMID: 28285515]
[33]
Ahmadpour E, Pishkarie-Asl R, Spotin A, et al. Sero-molecular evaluation of Toxoplasma gondii infection among HIV-positive patients. Trans R Soc Trop Med Hyg 2019; 113(12): 771-5.
[http://dx.doi.org/10.1093/trstmh/trz082] [PMID: 31495900]
[34]
Alavi SM, Jamshidian R, Salmanzadeh S. Comparative study on toxoplasma serology among HIV positive and HIV negative illicit drug users in Ahvaz, Iran. Caspian J Intern Med 2013; 4(4): 781-4.
[PMID: 24294474]
[35]
Aghaee R, Saki S, Didehdar M, Hajihossein R, Eslamirad Z. Epidemiologic evaluation of toxoplasmosis and leading risk factors in HIV/AIDS patients in Arak City, Iran. Australas Med J 2017; 10(10): 865-9.
[http://dx.doi.org/10.21767/AMJ.2017.3099]
[36]
Arefkha N, Sarkari B, Afrashteh M, Rezaei Z, Dehghani M. Toxoplasma gondii: The prevalence and risk factors in HIV-infected patients in Fars province, southern Iran. Iran Red Crescent Med J 2018; 20(6): e66521.
[http://dx.doi.org/10.5812/ircmj.66521]
[37]
Ebrahim-Saraie HS, Heidari H, Mousavi S, Asefi H, Abadi A, Afsar-Kazerooni P, et al. Toxoplasma gondii seroprevalence and related risk factors in patients with HIV in Iran. Arch Hell Med 2018; 35(3): 400-4.
[38]
Nazari N, Bozorgomid A, Janbakhsh A, Bashiri F. Toxoplasma gondii and human immunodeficiency virus co-infection in western Iran: A cross sectional study. Asian Pac J Trop Med 2018; 11(1): 58.
[http://dx.doi.org/10.4103/1995-7645.223562]
[39]
Shafieenia S, Saki J, Khademvatan S, Moradi-Choghakabodi P. Molecular and serological evaluation of toxoplasmosis in AIDS cases in southwest iran. Jundishapur J Microbiol 2018; 11(12)
[http://dx.doi.org/10.5812/jjm.77044]
[40]
Shafiei R, Riazi Z, Sarvghad M. Prevalence of IgG and IgM anti-Toxoplasma gondii antibodies in HIV positive patients in northeast of Iran. Iran J Pathol 2011; 6(2): 68-72.
[41]
Hosseini SA, Sharif M, Sarvi S, et al. Genetic characterization of Toxoplasma gondii in Iranian HIV positive patients using multilocus nested-PCR-RFLP method. Parasitology 2020; 147(3): 322-8.
[http://dx.doi.org/10.1017/S0031182019001598] [PMID: 31727203]
[42]
Wang ZD, Wang SC, Liu HH, et al. Prevalence and burden of Toxoplasma gondii infection in HIV-infected people: A systematic review and meta-analysis. Lancet HIV 2017; 4(4): e177-88.
[http://dx.doi.org/10.1016/S2352-3018(17)30005-X] [PMID: 28159548]
[43]
Ghorbani M, Edrissian GH, Afshar A. Serological survey of human toxoplasmosis in mountainous regions of the north-west and south-west parts of Iran (1976–1977). Trans R Soc Trop Med Hyg 1981; 75(1): 38-40.
[http://dx.doi.org/10.1016/0035-9203(81)90011-0] [PMID: 7022791]
[44]
Shahmoradi A, Daryani A, Hajizadeh A. Seroepidemiological survey of toxoplasmosis in individuals referred to Health Center of Roodsar, Gilan. J Shahid Beheshti Uni Med Sci 1998; 4: 7-12.
[45]
Daryani A, Sarvi S, Aarabi M, et al. Seroprevalence of Toxoplasma gondii in the Iranian general population: A systematic review and meta-analysis. Acta Trop 2014; 137: 185-94.
[http://dx.doi.org/10.1016/j.actatropica.2014.05.015] [PMID: 24887263]
[46]
Foroutan-Rad M, Khademvatan S, Majidiani H, Aryamand S, Rahim F, Malehi AS. Seroprevalence of Toxoplasma gondii in the Iranian pregnant women: A systematic review and meta -analysis. Acta Trop 2016; 158: 160-9.
[http://dx.doi.org/10.1016/j.actatropica.2016.03.003] [PMID: 26952970]
[47]
Shimelis T, Tebeje M, Tadesse E, Tegbaru B, Terefe A. Sero-prevalence of latent Toxoplasma gondii infection among HIV-infected and HIV-uninfected people in Addis Ababa, Ethiopia: A comparative cross-sectional study. BMC Res Notes 2009; 2(1): 213.
[http://dx.doi.org/10.1186/1756-0500-2-213] [PMID: 19852805]
[48]
Falusi O, French AL, Seaberg EC, et al. Prevalence and predictors of Toxoplasma seropositivity in women with and at risk for human immunodeficiency virus infection. Clin Infect Dis 2002; 35(11): 1414-7.
[http://dx.doi.org/10.1086/344462] [PMID: 12439806]
[49]
Shapiro K, Bahia-Oliveira L, Dixon B, et al. Environmental transmission of Toxoplasma gondii: Ocysts in water, soil and food. Food Waterborne Parasitol 2019; 15: e00049.
[http://dx.doi.org/10.1016/j.fawpar.2019.e00049] [PMID: 32095620]
[50]
Naito T, Inui A, Kudo N, et al. Seroprevalence of IgG anti-toxoplasma antibodies in asymptomatic patients infected with human immunodeficiency virus in Japan. Intern Med 2007; 46(14): 1149-50.
[http://dx.doi.org/10.2169/internalmedicine.46.6402] [PMID: 17634718]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy