Publication:

Seroprevalence of Toxoplasma gondii in HIV infected cases and its association with CD4 count in Silchar medical college and hospital

Background Toxoplasmosis caused by the intracellular coccidian parasite Toxoplasma gondii is one the most common AIDS defining condition in HIV infection. It may produce fatal consequences if gains upper hand in immunocompromised states like HIV infection or due to reactivation of latent disease or new infection. Toxoplasma encephalitis, affecting 15-40% of world’s PLHIV, is the most common opportunistic parasitic co-morbidity conventionally when CD4 count falls below 200/µl. But there has also been reports of asymptomatic toxoplasma IgG seropositivity in PLHIV with CD4 count in the range of 200-500/µl. This study was carried out to find the prevalence of Toxoplasma IgG seropositivity and to determine the association of Toxoplasma gondii seropositivity with CD4 count in HIV infected cases in south Assam.

Methods The 200 HIV infected cases with CD4 count <500/µl attending ICTC, ART centre and various clinical departments were screened by Toxoplasma IgG ELISA over 1 year.

Result It was found that 94 HIV infected cases were seropositive for Toxoplasma IgG and in which CD4 count was significantly less than 200/µl in 54% cases and in the range of 200-500/µl in remaining 46% cases.

Conclusions This sero-surveillance revealed anti-Toxoplasma gondii IgG in 47% cases. IgG seropositivity was significantly higher in cases on ART and in females with history of first trimester abortion. The finding of this study calls for initiation of prophylaxis against Toxoplasma routinely even in HIV cases of this region with CD4count in 200-500/µl range as quite good proportion of Toxoplasma seropositive HIV cases have CD4 count in this range apart from the conventionally vulnerable group with CD4 count below 200/µl.