Abstract

Problem statement: In situations of immunodeficiency, Toxoplasma gondii emerges as a life-threatening infection. Toxoplasma gondii is transmitted parenterally, flourish in immunocompromised subjects and, most toxoplasma infections are asymptomatic. Studies have shown that there is a immunodeficiency in renal failure patient such as hemodialysis patients and these patients have a high risk for many infections. There is no evidence about toxoplasmosis in hemodialysis patients in Iran. Approach: In the present study, we aimed to investigate the prevalence of anti-T. gondii antibodies in hemodialysis patients with chronic renal failure. This case-control study was carried out on 44 hemodialysis patients and 44 healthy controls for the prevalence of anti-T. gondii antibodies by ELISA. Anti-IgG, IgM and IgA T. gondii antibodies positivity were found to be 26 (59.10%), 3 (6.80%) and 3 (6.80%) of the 44 hemodialysis patients, respectively and 16 (36.40%) of the 44 control subjects were Anti-IgG T. gondii antibodies positivity and all of control subjects were negative for Anti-IgM and IgA T. gondii antibodies. The difference between them was statistically significant (p = 0.032). In addition, an increase of the seropositivity rate was detected with increasing length of time on hemodialysis treatment, indicating a statistically significant difference between these 2 parameters (p<0.001). Results: These findings confirm a high prevalence of toxoplasma infection in hemodialysis patients and these patients are a risk group for toxoplasma infection. Results showed that 3 hemodialysis patients had an acute and active infection. Conclusion: Moreover, it is recommended that hemodialysis patients who are susceptible to toxoplasma infections should be identified by T. gondii IgG and IgM and/or IgA specific serological tests. Therefore, patients undergoing hemodialysis should be screened for toxoplasma before dialysis to prevent the dissemination of this infection through the hemodialysis procedure.

Highlights

  • Toxoplasmosis is a cosmopolitan zoonotic disease caused by the parasitic protozoan Toxoplasma gondii (Chen and Tan, 2009)

  • As there is not any document about this infection in hemodialysis patients in IRAN, this study aimed to assess the risk of severe toxoplasmosis in patients with chronic renal failure undergoing haemodialysis by monitoring IgG, IgM and IgA antibodies to T. gondii

  • We used Enzyme-Linked Immunosorbent Assay (ELISA) kits purchased from the comercial manufacturer DIA.PRO (Diagnostic Bioprobes Srl. [20128]-Italy), for determination of anti-T. gondii IgG and IgM antibodies and IBL (International GmbH RE58241-Germany), for determination of anti-T. gondii IgA antibody, which were performed following the manufacturers instructions

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Summary

INTRODUCTION

Toxoplasmosis is a cosmopolitan zoonotic disease caused by the parasitic protozoan Toxoplasma gondii (Chen and Tan, 2009). In about 20% of Toxoplasma cases, acute infection is accompanied by febrile lymphadenopathy, asthenia and lymphomonocytosis, with the course of infection being self-limited (Feldman, 1968) Immunocompromised hosts, especially those with impaired cellular immunity, are at risk of recrudescence of chronic infection and dissemination, with the occurrence of fulminating disease. As there is not any document about this infection in hemodialysis patients in IRAN, this study aimed to assess the risk of severe toxoplasmosis in patients with chronic renal failure undergoing haemodialysis by monitoring IgG, IgM and IgA antibodies to T. gondii. This is the first study of Toxoplasmosis in Irania hemodialysis patients

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