Purpose

Immunocompromised patients may be at risk for reactivation of the toxoplasmosis infection, because of defection in cell-mediated immunity. Therefore, early diagnosis would be highly desirable in these individuals. This case–control study was designed to increase information about toxoplasmosis in hemodialysis (HD) patients in Guilan province, Iran.

Methods

The study was performed among 150 patients and 150 controls referred to hospitals of Guilan University of Medical Sciences during 2018–2019. Questionnaire forms, including demographic and epidemiological information, were completed. Peripheral blood samples were taken for serum separation and were collected into tubes and then kept at − 20 °C until use. IgG and IgM antibodies to Toxoplasma gondii were detected by a commercial ELISA kit. Accordingly, IgG absorbance levels < 9 were considered negative, 9–11 was considered borderline, and > 11 was positive; IgM absorbance levels < 0.9 were considered negative, 0.9–1.1 was assumed to be borderline, and > 1.1 was positive.

Results

Throughout the study, 72.0% of HD patients and 64.7% of the control group were positive for anti-Toxoplasma IgG antibody subsequently. 2% of HD patients and 0.7% of the control group were positive for anti-Toxoplasma IgM antibody and these difference weren’t significant between control and ones with HD (P > 0.05). There was no significant difference between dialysis duration factor and the seropositivity rate. Seroprevalence of T. gondii infection did not vary significantly with age, educational level, residence and presence of a cat at home. On the contrary, seroprevalence varied significantly with gender and consumption of raw vegetables.

Conclusion

Because of the high percentage of positivity for Toxoplasma IgG antibodies in hemodialysis patients, we suggest a periodically screening program to carry out for monitoring and evaluating the possible dissemination of toxoplasmosis during hemodialysis.

中文翻译：

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血液透析患者弓形虫的血清流行病学和相关危险因素。

目的

由于细胞介导的免疫缺陷，免疫功能低下的患者可能有再次激活弓形虫感染的风险。因此，这些人非常需要早期诊断。本病例对照研究旨在增加有关伊朗桂兰省血液透析 (HD) 患者弓形体病的信息。

方法

该研究是在 2018-2019 年转诊到桂兰医科大学医院的 150 名患者和 150 名对照者中进行的。完成了包括人口统计和流行病学信息在内的问卷调查表。外周血样本用于血清分离并收集到管中，然后保存在-20°C直至使用。弓形虫的 IgG 和 IgM 抗体通过商业 ELISA 试剂盒检测。因此，IgG 吸光度水平 < 9 被认为是阴性，9-11 被认为是临界值，> 11 被认为是阳性；IgM 吸光度水平 < 0.9 被认为是阴性，0.9-1.1 被认为是临界值，> 1.1 被认为是阳性。

结果

在整个研究过程中，72.0% 的 HD 患者和 64.7% 的对照组随后抗弓形虫IgG 抗体呈阳性。2%的HD患者和0.7%的对照组抗弓形虫IgM抗体阳性，对照组与HD组差异无统计学意义（P  >0.05）。透析持续时间因素和血清阳性率之间没有显着差异。的血清流行病学弓形虫感染并没有随着年龄的增长，受教育程度，居住和存在在家猫的显著变化。相反，血清阳性率随性别和生蔬菜的消费而显着变化。

结论

由于血液透析患者中弓形体IgG 抗体阳性的比例很高，我们建议定期进行筛查计划，以监测和评估血液透析期间弓形体病的可能传播。