Low Seroprevalence of Toxoplasma Gondii in People Living With Human Immunodeficiency Virus: Is it Possible to Ignore?
Vahibe Aydın Sarıkaya1, Recep Balık1, Serdar Turhan1, Seniha Şenbayrak1, Serpil Erol1, Asuman Inan Şengöz1, Sebahat Aksaray2, Nurgül Ceran11Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Istanbul, Türkiye2Department of Medical Microbiology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Istanbul, Türkiye
INTRODUCTION: Immunocompromised individuals, especially people living with human immunodeficiency virus (HIV), are vulnerable to severe complications from latent Toxoplasma gondii reactivation. This study investigated T. gondii seropositivity in people living with HIV and its association with demographic and clinical factors to identify high-risk groups.
METHODS: Between January 1, 2020, and June 1, 2025, 1189 people living with HIV from the infectious diseases outpatient clinic were included. Demographic data, CD4+ T lymphocyte counts, HIV ribonucleic acid levels, and T. gondii immunoglobulin G (IgG)/immunoglobulin M results were retrospectively collected, and seropositivity rates and their associated factors were statistically analyzed.
RESULTS: Of the 1189 people living with HIV included in the study, 88.7% were male (n=1055) and 11.3% were female (n=134), with a mean age of 38.2±9.6 years. Serological evaluation revealed that T. gondii IgG antibodies were positive in 31.4% of the patients (n=374). Among the study population, 118 patients (9.9%) had a CD4+ T lymphocyte count below 100 cells/mm3 at the time of admission. Of these patients, 48 (40.7%) were seropositive for T. gondii IgG. In contrast, among the 1071 patients with a CD4+ T cell count ≥100 cells/mm3, 326 (30.4%) were IgG positive. T. gondii seropositivity was significantly higher in patients with CD4+ T lymphocyte counts <100 cells/mm3, and this difference was statistically significant (p=0.030). Seropositivity rates increased significantly with age (p<0.001), lowest in 18–25 (16.5%) and highest in ≥50 years (64.88%).
DISCUSSION AND CONCLUSION: Our study highlights the combined impact of age-related cumulative exposure and environmental factors on the epidemiology of T. gondii infection among people living with HIV. Higher seronegativity in younger patients indicates reduced exposure, potentially increasing the risk of primary infection in the immunosuppressed. Thus, T. gondii serological screening remains essential, especially in those with low CD4+ counts.
Keywords: CD4+ T lymphocyte, Human immunodeficiency virus, Seroprevalence, Toxoplasma gondii.
Manuscript Language: English