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Research Article
Ali Rostami
Babol University of Medical Science
Corresponding Author
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Background: Toxoplasma gondii infection is one of the most prevalent opportunistic and life-threatening infections in people living with HIV (PLWH). Here, we undertook a meta-analysis to estimate the global prevalence of latent (LT) and acute (AT) toxoplasmosis in PLWH.
Methods: Eligible studies reporting the prevalence of LT or AT in PLWH were searched from January 1980 to July 2020, using PubMed/MEDLINE, Scopus, Web of Sciences, SciELO and Embase databases. We used a random effects model to calculate pooled prevalence estimates with 95% confidence intervals (CI) and evaluated overall burden of co-infection worldwide. Countries were categorised based on World Health Organization regions. Multiple subgroup and meta-regression analyses were performed.
Results: From 4,024 studies identified, 150 (involving 44,473 PLWH) and 65 (involving 17,705 PLWH) studies met the inclusion criteria, for LT and AT in PLWH, respectively. The overall prevalence rates of LT and AT in PLWH were 37.4% (95% CI, 33.4–4.4) and 1.3% (95%CI, 0.9–1.8%), respectively. We estimated that, worldwide, approximately 14.2 and 0.5 million PLWH are affected by LT and AT, respectively. The highest and lowest burden of LT and AT were seen in the African and Western Pacific regions, respectively. Moreover prevalence rates were highest in countries with low levels of income and human development indexes. We indicated that eating raw/undercooked meat, frequent contact with soil, low numbers of CD4+ T lymphocytes and older age were significant risk factors of toxoplasmosis in PLWH.
Conclusion: Our findings revealed that, a high number of PLWH are exposed to or infected with T. gondii. These findings suggest a need for more routine testing, care of, and treatment for T. gondii infection in all PLWH, and educating these patients about risk factors and preventive measures to reduce the burden of both latent and acute toxoplasmosis.
Keywords
Latent toxoplasmosis, Acute toxoplasmosis, HIV-Infected people, Global prevalence, Burden, Meta-analysis
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Ali Rostami
Babol University of Medical Science
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 16 Dec, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Toxoplasma gondii infection is one of the most prevalent opportunistic and life-threatening infections in people living with HIV (PLWH). Here, we undertook a meta-analysis to estimate the global prevalence of latent (LT) and acute (AT) toxoplasmosis in PLWH.
Methods: Eligible studies reporting the prevalence of LT or AT in PLWH were searched from January 1980 to July 2020, using PubMed/MEDLINE, Scopus, Web of Sciences, SciELO and Embase databases. We used a random effects model to calculate pooled prevalence estimates with 95% confidence intervals (CI) and evaluated overall burden of co-infection worldwide. Countries were categorised based on World Health Organization regions. Multiple subgroup and meta-regression analyses were performed.
Results: From 4,024 studies identified, 150 (involving 44,473 PLWH) and 65 (involving 17,705 PLWH) studies met the inclusion criteria, for LT and AT in PLWH, respectively. The overall prevalence rates of LT and AT in PLWH were 37.4% (95% CI, 33.4–4.4) and 1.3% (95%CI, 0.9–1.8%), respectively. We estimated that, worldwide, approximately 14.2 and 0.5 million PLWH are affected by LT and AT, respectively. The highest and lowest burden of LT and AT were seen in the African and Western Pacific regions, respectively. Moreover prevalence rates were highest in countries with low levels of income and human development indexes. We indicated that eating raw/undercooked meat, frequent contact with soil, low numbers of CD4+ T lymphocytes and older age were significant risk factors of toxoplasmosis in PLWH.
Conclusion: Our findings revealed that, a high number of PLWH are exposed to or infected with T. gondii. These findings suggest a need for more routine testing, care of, and treatment for T. gondii infection in all PLWH, and educating these patients about risk factors and preventive measures to reduce the burden of both latent and acute toxoplasmosis.
Figure 1
Figure 1
Figure 1
Figure 2
Figure 2
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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