Sero-molecular evaluation of Toxoplasma gondii infection among HIV-positive patients

Association of polymorphism of IL-17A, IL-17F, and IL-6 with Toxoplasma gondii infection susceptibility in HIV/AIDS patients in Shiraz, southern Iran

INTRODUCTION

Toxoplasma gondii infection is considered as one of the most important opportunistic infections and cause of death in HIV patients.

METHODS

In this cross-sectional study, 334 HIV positive patients were included. The molecular test was performed by the restriction fragment length polymorphism-polymerase chain reaction method. Allelic frequency, haplotype analyses, and linkage disequilibrium were calculated. The odds ratio was calculated. The linear regression model was used to analysis of interleukin (IL)-17A, IL-17F, and IL-6 single-nucleotide polymorphism genotypes in HIV patients with and without toxoplasmosis.

RESULTS

In total, 95 tested'patients (28.4%) were positive for toxoplasmosis. The risk of toxoplasma infection in the current study did not correlate with IL-17 and IL-6 polymorphism and the risk of contracting toxoplasma was also not significantly correlated in this study. There was no association between the frequency of alleles and the risk of toxoplasma infection in IL-17 haplotype analysis.

CONCLUSION

The findings of this study revealed that there were significant differences in the serum levels of IL-6 and IL-17A, but not IL-17F, between the case and control groups in various genetic models. However, these polymorphisms did not show a significant relationship with toxoplasma infection in HIV-positive patients. This study represents the first investigation in Iran to explore the role of IL-6 and IL-17 polymorphisms in toxoplasma infection among HIV-positive patients.

Molecular investigation of Toxocara infection from the serum of people living with HIV in Alborz, Iran

BACKGROUND

Toxocara infection is one of the most common neglected infections of poverty and a helminthiasis of global importance. Traditional diagnostic methods such as antibodies detection in serum samples are limited due to cross-reactivity and poor sensitivity. The use of molecular base methods for diagnosis of Toxocara infection in Iran has not been fully explored. The purpose of the current study was to estimate the prevalence of Toxocara infection from serum samples of people living with HIV in Alborz province, Iran using serological and molecular methods.

METHODS

Blood samples were collected from 105 people living with HIV. Epidemiological data of participant were obtained through a structured questionnaire to investigate the risk factors. Patients CD4⁺ T cell count were recorded. Anti-Toxocara IgG antibodies were detected by ELISA, with a cut-off point of 11. PCR was performed to detect genetic material of Toxocara species in the serum samples.

RESULTS

The mean CD4⁺ count in HIV-infected individuals with positive toxocariasis serology was 255.1 ± 21.6 cells/µL. Seropositivity for Toxocara species was observed in 12/105 (11.4%) people living with HIV. Three samples gave positive results on PCR analysis. Based on the data, a statistically significant relationship was found between anti-Toxocara IgG antibodies seropositivity and underlying conditions (p = 0.017). No significant statistical association was observed between seropositivity for Toxocara and gender, age, exposure to domestic animals or pet keeping, education levels, and occupation (p > 0.05). The findings of PCR confirmed Toxocara DNA in 3/12 (25.0%) serum samples.

CONCLUSION

These findings demonstrated for the first time that people living with HIV from Alborz province, are being exposed to this zoonosis and a relatively high seroprevalence of Toxocara in HIV/AIDS people needs comprehensive health education regarding personal hygiene and how to avoid exposure to this parasite infection, especially in people with an impaired immune system.

Prevalence of Toxoplasma gondii in HIV-Infected Individuals in Iran: A Systematic Review and Meta-Analysis

INTRODUCTION

Toxoplasma gondii is an obligate intracellular protozoan that can infect almost all warm-blooded animals, including humans. Patients with co-infection with toxoplasmosis and HIV have a 30-40% risk of developing toxoplasmosis encephalitis. This study aimed to describe the epidemiology and burden of Toxoplasma gondii in HIV-infected individuals in Iran.

METHODS

We searched the five English databases (Science Direct, PubMed, Scopus, Ovid, Embase, and Cochrane) and four Persian databases (Scientific Information Database (SID), Iran Medex, Iran Doc, and Magiran) with the terms of (Toxoplasma gondii OR "toxoplasmosis") AND (HIV OR "AIDS" OR immunodeficiency OR acquired immune deficiency syndrome) AND (Seroprevalence) AND (Seroepidemiologic Studies) AND (Elisa OR IgG) AND (PCR) AND (Iran) by two authors up to Feb 2021. Studies were included if they investigated people with HIV infection and presented data that allowed us to establish the prevalence of Toxoplasma gondii infection in Iran.

RESULTS

According to the inclusion/exclusion criteria, 15 studies were selected. A total number of 2275 HIV-infected individuals were tested and evaluated for toxoplasmosis from 2005 up to 2018 in different regions of Iran. The weighted overall prevalence of toxoplasmosis in HIV-infected individuals with Elisa was obtained using a random-effects model, which was estimated at 47% (95% CI = 31% - 62%). Also, the Weighted overall prevalence of toxoplasmosis in HIV-infected individuals with PCR was obtained using a random-effects model, which was estimated at 7% (95% CI = 3% - 12%).

CONCLUSION

According to the results of this study, it can be clearly understood that a large population of HIV patients living in Iran have toxoplasmosis. Therefore, due to the high susceptibility of these groups to toxoplasmosis, healthcare professionals must consider measures such as training in the ways of transmission and prevention of the infection to this high-risk group in order to reduce the risk of infection.

Seronegative Infection with Toxoplasma gondii in Asymptomatic Human Immunodeficiency Virus Type 1 (HIV-1)-Infected Patients and in Blood Donors

Background: Toxoplasmosis is a common opportunistic infection in AIDS patients. The routine diagnostics is based on serologic testing and IgG avidity index, but it may have limited utility in immunodeficient patients; thus, it is recommendable to detect T. gondii DNA in subjects with advanced HIV disease. The results of the studies published so far focused on patients with clinical symptoms of toxoplasmosis. Our study encompassed a group of HIV-infected subjects on cART therapy, without immunological disturbances and clinical symptoms of T. gondii infection. Methods: The study was retrospective, and samples were collected between 2013 and 2016. We evaluate the prevalence of serological (IgM, IgG, and avidity IgG) and molecular (DNA) T. gondii infection markers in asymptomatic HIV-infected patients and the control group using serologic (ELISA) and quantitative (real-time PCR) molecular testing. Results: Of 152 HIV-infected in routine follow-up tested for T. gondii IgM and IgG, 6 (3.9%) and 50 (32.9%) were positive, respectively. Of 168 serum samples from blood donors, 1 (0.6%) and 49 (29.2%) were IgM⁺ and IgG⁺ positive, respectively. IgM seroprevalence in HIV-infected patients was significantly higher than in blood donors. T. gondii DNA (genotype II) was identified in 47 (30.9%) HIV-infected patients, with 13 (8.6%) IgM⁻IgG⁻ samples. In blood donors, T. gondii DNA was present in 15 (8.9%) IgM⁻IgG⁻. Conclusions: In both groups, T. gondii DNA was detectable in seronegative subjects, implying the need to supplement the routine serological testing via the molecular method. It can help the accurate monitoring of the reactivation of infection in asymptomatic HIV-infected persons, and the quick introduction of specific therapy, in blood donors, would be of high importance for safe blood donations.

Anti-Toxoplasma activity and chemical compositions of aquatic extract of Mentha pulegium L. and Rubus idaeus L.: An in vitro study

This study aimed to determine the chemical compositions of crude aquatic extracts of M. pulegium L. and R. idaeus L., and their anti-Toxoplasma activity. Crude aquatic extraction of aerial parts of R. idaeus L. and M. pulegium L. was performed. GC-MS and HTPLC analyses were carried out. MTT assay was performed on Vero cells treated by different concentrations (Log -10 from 10-1 to 10-6) of the extracts. The anti-Toxoplasma activity of the concentrations was investigated using vital staining. Menthol (99.23%) and limonene (0.227%) were the major compounds of the aquatic extract of M. pulegium L. Phytochemical compositions of R. idaeus L. were terpenoids, esterols, and flavonoids. The cell toxicity of M. pulegium L. was lower than R. idaeus L. (CC50 > 10-2 versus. ≥ 10-4). Aquatic extract of M. pulegium L. showed higher anti-Toxoplasma activity (LC50 ≥ 10-6) than R. idaeus L. (LC50 ≥ 10-5). Statistically significant cell toxicity and anti-Toxoplasma activity (p < .05) were seen regarding the different concentrations of R. idaeus L. and M. pulegium L. Both R. idaeus L. and M. pulegium L. revealed anti-Toxoplasma activities. Cell toxicity of R. idaeus L. was significantly higher than M. pulegium L. M. pulegium L. extract could be more applicable due to its lower cell toxicity.

In vitro Evaluation of Mannosylated Paromomycin-Loaded Solid Lipid Nanoparticles on Acute Toxoplasmosis

Toxoplasma gondii is a zoonotic intracellular protozoan with worldwide distribution. Acute and severe toxoplasmosis are commonly reported in patients who suffer from acquired/congenital immune deficiency. This study aimed to synthesize mannosylated paromomycin-loaded solid lipid nanoparticles (PM-SLN-M) and to evaluate them on acute toxoplasmosis. SLN was synthesized and then loaded by 7 mg/mL paromomycin sodium. Mannose coating was performed, and after washing, the size, zeta potential, and loading percentage were calculated. To evaluate the cell toxicity, an MTT assay was performed on Vero cells by different concentrations (log 10^-1) of SLN, PM-SLN-M, and PM-SLN. In addition, the anti-Toxoplasma effects were also evaluated using trypan-blue staining and scanning electron microscopy (SEM). An MTT assay was also employed to evaluate the effects of PM and PM-SLN-M on intracellular Toxoplasma. A 6-month stability test of PM-SLN and PM-SLN-M represented that the characteristics all remained constant. The cell viability assay demonstrated that PM-SLN-M had lower cell toxicity (<20%) compared to PM-SLN (<30%) and PM (<40%). Statistical analysis showed that PM-SLN-M significantly killed ~97.555 ± 0.629 (95% CI: 91.901 to 103.209; P < 0.05) of T. gondii tachyzoites. More than 50% of Toxoplasma-infected Vero cells remained viable in concentrations more than 0.07 μg/mL and 7 μg/mL of PM and PM-SLN-M, respectively. SEM analysis showed that T. gondii tachyzoites were changed in both size and morphology facing with PM-SLN-M. Our findings indicated that synthesized PM-SLN-M had anti-Toxoplasma activity without significant host cell toxicity at the highest concentration. Our study demonstrated that PM was able to kill intracellular Toxoplasma in lower concentration in comparison to PM-SLN-M, although PM-SLN-M showed lower cytotoxic effects on Vero cells.