Sero-Molecular Detection of Toxoplasma Gondii Infection among HIV-Positive Patients in Khartoum : A Cross Sectional Study

Abstract

Background and Aim : Toxoplasmosis is one of the most common comorbidities in HIV-positive patients with CD4+ T lymphocytes below 200 cells/μl. Toxoplasmosis with encephalitis may affect HIV infection, in particular in patients with developing AIDS. Early diagnosis and treatment of toxoplasmosis reduces the mortality rate in HIV-positive people. The aim of this study was to estimate the seroprevalence of Toxoplasma gondii infection in HIV-positive patients in Khartoum, Sudan using serological and molecular methods. Methods : This was a descriptive cross sectional, hospital based study, blood sample were collected from 100 participants; out of them were 50 HIV/AIDS patients and 50 were healthy Blood donors attending HIV Center -Omdurman Hospital, and Sudan Heart Center blood bank respectively. Socio- demographic data were collected by structured questionnaire. Of the 50 HIV/AIDS patients, 25 (50%) were from each gender, their age ranged between 22 and 62 with mean of 39.5+10.69. They were classified into two age groups; from 22 to 42 years, and from 43 to 62 years, and their distribution was 29 (58%), and 21 (42%) respectively. According to the clinical stage they were classified into the four clinical-stage groups and their distribution was as following: 06 (12.0%) in stage 1, 02 (04%) in stage 2, 40 (80.0%) in stage 3, and 02 (04.0%) in stage 4. Twelve of them (22%) were under ART treatments. The 50 blood donors on their hand were all males, their age was ranged between 18 and 42 years old. Regarding their educatio, 15 (30%) were educated, while the remaining 35 (70%) were none educated. Mentioning their marital status 10 (20%) were married, while 40 (80%) were single. Regarding the contact with cats 25 (50%) has contact with cats. All samples collected were tested for anti-Toxoplasma IgG and IgM antibodies by ELISA, and by PCR for detection of Toxoplasma DNA.. Results: Out of the 50 HIV/AIDS patients; Anti-Toxoplasma IgM was detected in two patients (04%), while IgG was detected in 08 (16%) patients, the Toxoplasma DNA was detected in three (06%) patients.Regarding the blood donors group; all studied blood donors showed negative results for anti-toxoplasma IgM, while 16 (32%) showed positive anti-Toxoplasma IgG.No blood donors sample was detected positive for Toxoplasma DNA with PCR. There were no significant differences in comparison between the blood donors and the HIV/AIDS patients regarding serological and molecular toxoplasma test results. Conclusion : The current study showed a relatively high seroprevalance of anti-T.gondii IgG and low IgM antibodies in HIV-positive patients in comparison with previous studies in Sudan. Considering the relatively high seroprevalance rate of toxoplasma infection in blood donors reported in this study, toxoplasmosis should be considered as a significant transfusion risk.