Toxoplasma gondii, HBV, and HCV co‐infection and their correlation with CD4 cells among Iranian HIV‐positive patients

Abstract

AbstractIntroductionHuman immunodeficiency virus (HIV/AIDS) infected patients have a higher risk of opportunistic infections (OIs) depending on their immunological status, especially CD4 + cell count. Toxoplasma gondii, hepatitis C virus (HCV), and hepatitis B virus (HBV) are important OIs among Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) patients. However, little is known about co‐infection of these pathogens among HIV‐infected individuals and their correlation with the patient's CD4 + cell count. Hence, this study aimed to investigate the serological and molecular status of T. gondii infection among HIV‐infected individuals who had co‐infection with HBV and HCV infections.MethodsA total of 100 HIV/AIDS patients in two cities in the southwest of Iran was tested for T. gondii Immunoglobulin G (IgG) and Immunoglobulin M (IgM) antibodies as well as DNA detection by polymerase chain reaction (PCR) targeting the RE gene. HBV and HCV were detected by hepatitis B surface antigen (HBsAg) test, hepatitis C antibody (HCV Ab) test, and Real‐Time PCR. The number of CD4 + cell counts was determined by Flow cytometry.ResultsAnti‐T. gondii IgG was positive in 22% of the patients, but anti‐T. gondii IgM and PCR were negative in all samples. HBV and HCV were positive in 8% and 33% of the patients, respectively. Co‐infections were as followed: HIV + HCV (16%), HIV + HCV + T. gondii (11%), HIV + T. gondii (5%), HIV + HBV (1%), HIV + HBV + T. gondii (1%), HIV + HBV + HCV (1%), and HIV + HBV + HCV + T. gondii (5%). A significant decline in CD4 + cell counts was found in such co‐infection groups (HIV + T. gondii, HIV + HCV + T. gondii, and HIV + HBV + HCV + T. gondii) compared with the HIV mono‐infection group.ConclusionsOur study showed that co‐infections of T. gondii, HCV, and HBV were common among HIV‐infected patients and co‐infections had a negative correlation with CD4 + cell counts of the patients.