Seroprevalence of Toxoplasma gondii IgG antibody in HIV-infected patients at the Lagos University Teaching Hospital

Vincent O Osunkalu¹, Sulaimon A Akanmu¹, Nkolika J Ofomah¹, Igwebuike V Onyiaorah², Adewumi A Adediran¹, Ralph O Akinde³, Ifeanyi A Onwuezobe^4
1Department of Haematology and Blood Transfusion, College of Medicine Idi-Araba, Lagos, Nigeria; ²Department of Histopathology, Nnamdi Azikiwe University, Nnewi Campus, Lagos, Nigeria; ³Department of Morbid Anatomy, College of Medicine Idi-Araba, Lagos, Nigeria; ⁴Department of Microbiology, University of Calabar, Nigeria

Background: Toxoplasmosis is caused by infection with a ubiquitous intracellular protozoan parasite, Toxoplasma gondii. With the advent of the HIV pandemic in Nigeria, toxoplasmic encephalitis has become one of the more frequent opportunistic infections and the most commonly implicated cause of focal brain lesions complicating the course of AIDS.
Objectives: This study was conducted to compare the pattern of seroprevalence of T. gondii (Toxo-IgG) antibodies among HIV-infected persons presenting with neurological complications and those without.
Materials and methods: Plasma specimens collected from 380 subjects were tested for Toxo-IgG antibodies by enzyme immunoassay technique and CD4 estimation by flow cytometry. Close-ended questionnaires were applied to all respondents to collect relevant data, with ethical approval from the hospital ethical committee. Plasma was obtained from two study groups comprising 300 HIV-positive respondents without neurological presentations, and 80 HIV-positive respondents with neurological complications.
Results: Seroprevalence of Toxo-IgG antibodies was 58% in the HIV-positive study group without neurological complications (of these, 79.2% were males and 38.5% were females) and 40% in the study group with neurological complications (46.2% of these were males and 28.6% were females). The overall seroprevalence of Toxo-IgG antibodies among the HIV-positive respondents (with and without neurological complications) was 54.2% (206 of 380). Seroprevalence of Toxo-IgG antibodies was lowest among the educated subjects (19% of the respondents with tertiary education) and among females in both study groups. A higher proportion of the subjects with neurological complications had CD4 cell count <100 cells/µL compared with respondents without neurological defects (39% vs 22.7%; P = 0.000), but the seroprevalence of Toxo-IgG antibodies was higher in subjects without neurological complications (45% vs 31.3%; P = 0.000).
Conclusion: Toxoplasmosis, though an important opportunistic infection in our environment, may not account for the majority of neurological complications observed in patients with HIV infection in our center.

Keywords: Toxoplasma gondii antibody (Toxo-IgG), seroprevalence, neurological complication