Toxoplasma Gondii Seropositivity in Renal Patients : Rate, Pattern , Predictors and Related Morbidity

H, Hamza; El-Taweel, Hend A; Abou-Holw, Sahar; Khalil, Safia; Wagdy, Eman

doi:10.12816/0010844

Cited by 9 publications

(20 citation statements)

References 31 publications

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“…The overall T. gondii seroprevalence rate among approximately a third of HD patients in the present study is lower than those previously reported among HD patients (61.7%) and renal transplant recipients (70.0%) in Alexandria [17]. Similarly, it is lower than the rates reported from Turkey (56.0–76.5%) [44, 45], Mexico (56.7%) [46] and Iran (56.7–73.7%) [47–49].…”

Section: Discussioncontrasting

confidence: 80%

Opportunistic parasitoses among Egyptian hemodialysis patients in relation to CD4+ T-cell counts: a comparative study

2019

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Background Some reports are available on the prevalence of opportunistic parasitoses among hemodialysis (HD) patients, yet there is a paucity of data on the association of CD4+ T-cell counts with such infections. Therefore, this study aimed to determine the prevalence of intestinal parasites and Toxoplasma gondii in relation to CD4+ counts among HD patients in Alexandria, Egypt. Methods A comparative cross-sectional study was conducted on 120 HD patients and 100 apparently healthy individuals between December 2014 and January 2016. Data and samples (stool and blood) were collected from the participants after obtaining their informed consent. Stool samples were examined for parasites after concentration and staining, EDTA-blood samples were used for CD4+ counting by flow cytometry, and sera were analyzed for anti- Toxoplasma IgM and IgG antibodies. Results A significantly higher prevalence rate of intestinal parasitoses was found among HD patients compared to apparently healthy individuals (52.5% vs. 12.0%, respectively), with absence of helminths. Cryptosporidium species (32.5%), B. hominis (24.2%) and microsporidia (11.7%) were the most frequent parasites among HD patients, while B. hominis (13.0%), Cryptosporidium species (11.0%) and G. lamblia (4.0%) were the most frequent parasites among their counterparts. Statistically significant differences in parasite infection rates between patients and their counterparts were found for Cryptosporidium species, B. hominis and microsporidia. However, parasite species were not significantly associated with diarrhea. On the other hand, the overall T. gondii seroprevalence rate among HD patients was significantly higher than that among their counterparts (33.3% vs. 8%, respectively). HD patients with CD4+ counts < 200 cells/μl were twice more exposed to intestinal parasitoses compared to those with counts ≥200 cells/μl, but the difference was not statistically significant. However, low CD4+ counts were significantly associated with higher rates of Cryptosporidium species, microsporidia and T. gondii . Conclusions Intestinal parasitoses and T. gondii infection rates are significantly higher among Egyptian HD patients compared to apparently healthy individuals, with Cryptosporidium species, B. hominis , microsporidia and T. gondii being the most frequent parasites. CD4+ counts < 200 cells/μl are significantly associated with Cryptosporidium species, microsporidia and T. gondii among HD patients. ...

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Section: Discussioncontrasting

confidence: 80%

Opportunistic parasitoses among Egyptian hemodialysis patients in relation to CD4+ T-cell counts: a comparative study

2019

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“…There are many case reports of toxoplasmosis in transplant recipients, including haematopoietic cell (Barcan et al, 2002), heart (Gajurel et al, 2015), liver (Hamza et al, 2015), and kidney (Petty et al, 2015) transplant patients. A previous study reported a higher prevalence of T. gondii infection in renal transplant recipients (Soltani et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Toxoplasma gondii Infection in Immunocompromised Patients: A Systematic Review and Meta-Analysis

Wang¹,

Liu

Ma³

et al. 2017

Front. Microbiol.

189

190

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Toxoplasma gondii has been suggested as an important opportunistic pathogen in immunocompromised patients. We conducted a global meta-analysis to assess the prevalence and odds ratios (ORs) of T. gondii infection in immunocompromised individuals. Electronic databases were reviewed for T. gondii infection in HIV/AIDS patients, cancer patients, and transplant recipients, and meta-analyses were conducted to calculate overall estimated prevalence and ORs using random or fixed-effects models. Totally, 72 eligible studies were included. The estimated pooled prevalence of T. gondii infection in immunocompromised patients and the control was 35.9 and 24.7% (p < 0.001), with an OR of 2.24, i.e., 42.1 and 32.0% for HIV/AIDS patients and the control (p < 0.05), 26.0 and 12.1% for cancer patients and the control (p < 0.001), and 42.1 and 34.5% for transplant recipients and the control (p > 0.05), whose estimated pooled ORs were 1.92 (95% CI, 1.44–2.55), 2.89 (95% CI, 2.36–3.55), and 1.51 (95% CI, 1.16–1.95), respectively. This study is the first to demonstrate that the immunocompromised patients are associated with higher odds of T. gondii infection, and appropriate prevention and control measures are highly recommended for these susceptible populations.

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“…Chronic renal diseases (of more than 2 years) correlate with a significant increase in T gondii positivity (OR = 11.842, CI = 1.376‐101.935). It was shown in the same study that patients with one or more blood transfusions had a high risk of T gondii positivity (OR = 8.782, CI = 3.231‐23.869), which was increased with increasing numbers of blood transfusions (OR = 24.626, CI = 9.378‐64.666) …”

Section: Discussionmentioning

confidence: 85%

“…Toxoplasma gondii seropositivity rate of IgG antibodies in 30 renal transplant recipients from Egypt was 70%, which was higher than that in healthy controls (30%). Nevertheless, no clinical manifestations were observed in these T gondii ‐seropositive patients …”

Section: Introductionmentioning

confidence: 93%

Toxoplasma infection in kidney donors and transplant recipients from Western Mexico: A one‐year follow‐up

Galván-Ramírez

Sánchez-Orozco

Andrade‐Sierra

et al. 2019

Transplant Infectious Dis

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Purpose: Solid organ transplant recipients are highly susceptible to Toxoplasma gondii infection. We aimed to describe the 12-month follow-up risk of seroconversion in renal transplant recipients.Methodology: Anti-T gondii antibodies were investigated in donors and recipients of renal transplants. In donors, anti-T gondii were evaluated before transplantation. In recipients, anti-T gondii were monitored over a 12-month period to evaluate potential seroconversion or reactivation. IgG and IgM anti-T gondii antibodies were investigated through enzyme immunoassay and Western blot. Molecular diagnosis was performed on peripheral blood leukocytes using PCR to amplify fragments corresponding to the T gondii B1 gene and the repetitive 529-bp element. Results:The basal frequency of seropositive IgG anti-T gondii antibodies was higher in donors than in recipients (38.4% vs 25.2%; P = .03). During the 12-month follow-up, the accumulated seroconversion to IgG and IgM antibodies was 3/99 (3.0%), and the accumulated reactivation was 11/99 (11.0%). None of the samples exhibited positivity to T gondii DNA. Conclusions:This study showed that there is an increased risk of seroconversion or reactivation in renal transplant recipients over a 12-month follow-up. Our data suggest that prophylaxis with trimethoprim and sulfamethoxazole effectively prevented toxoplasmosis, since neither T gondii DNA nor clinical toxoplasmosis was detected.

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Toxoplasma Gondii Seropositivity in Renal Patients : Rate, Pattern , Predictors and Related Morbidity

Cited by 9 publications

References 31 publications

Opportunistic parasitoses among Egyptian hemodialysis patients in relation to CD4+ T-cell counts: a comparative study

Opportunistic parasitoses among Egyptian hemodialysis patients in relation to CD4+ T-cell counts: a comparative study

Toxoplasma gondii Infection in Immunocompromised Patients: A Systematic Review and Meta-Analysis

Toxoplasma infection in kidney donors and transplant recipients from Western Mexico: A one‐year follow‐up

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