Human immunodeficiency virus (HIV) infection remains a major global health challenge, particularly in resource-limited settings where coinfections like toxoplasmosis exacerbate morbidity and mortality. Due to limited epidemiological and serological data on Toxoplasma gondii infection and its association with HIV disease progression, particularly in Egypt, this study aimed to assess the T. gondii serological profile in Egyptian HIV/acquired immunodeficiency syndrome (AIDS) patients compared with controls, and to identify independent predictors of anti-Toxoplasma IgM seropositivity. This cross-sectional study included 274 adult participants divided into two equal groups: HIV-positive and controls. IgG and IgM antibodies were detected via enzyme-linked immunosorbent assay (ELISA). HIV infection was confirmed by chemiluminescent microparticle immunoassay (CMIA), and viral load was measured by real-time PCR. IgM and isolated IgM (IgG-/IgM+) positivity were significantly higher, whereas dual seronegativity (IgG-/IgM-) was significantly lower in HIV patients (p<0.001, p<0.001, and p=0.037). However, IgG positivity, isolated IgG (IgG+/IgM-), and dual seropositivity (IgG+/IgM+) did not differ significantly. Median HIV viral load was 2,200 (IQR: 500-32,000) IU/mL, with most patients in stage 1 (99/137; 72.3%). Significant correlations were found between CD4 count, HIV stage, and viral load (all p<0.001). Both viral load and CD4 showed good discriminatory performance in predicting IgM seropositivity (AUC: 0.857 and 0.821, p<0.001). Multivariate analysis identified advanced HIV stage, high viral load, low CD4, and weight loss as independent predictors of IgM seropositivity (all p<0.001). HIV/AIDS patients have a significant burden of T. gondii infection. Targeted serological screening and integration of clinical, immunological, and virological markers are essential for early detection and management in high-risk individuals.
Mohamed et al. (Wed,) studied this question.