Korean J Med.  2009 Jun;76(6):713-721.

Clinical characteristics and prevalence of toxoplasma infection in human immunodeficiency virus-infected patients in South Korea

• Lee SH
• Lee SH
• Cha DH
• Lee SJ
• Kwak IS
• Chung JS
• Cho GJ
• Lee H
• Jung DS
• Moon CS
• Park JY
• Ko OB
• Shin KD

Abstract

BACKGROUND/AIMS: Toxoplasmic encephalitis (TE) is one of the most common causes of focal brain lesions, which complicate the course of acquired immunodeficiency syndrome (AIDS). There is wide geographic variation in the prevalence of toxoplasma infection. This study was performed to characterize toxoplasma infection in human immunodeficiency virus (HIV)-infected patients in South Korea.
METHODS
We retrospectively examined the incidence and clinical characteristics of TE in 683 HIV-infected patients who were enrolled between 1990 and 2008 at four university hospitals in Busan, Korea. We also assessed the seroprevalence of IgG antibodies to Toxoplasma gondii, risk factors for toxoplasma seropositivity, and seroconversion rates during the course of HIV infection.
RESULTS
Among 683 HIV-infected patients, six (0.9%) patients were diagnosed with TE. The incidence of TE was 0.34 per 100 person-years (py) during the study period. Of the 414 patients who had undergone serological examinations for Toxoplasma gondii, 35 (8.5%) patients were seropositive. Univariate analysis showed that the risk factors associated with toxoplasma seropositivity included increased age, heterosexual transmission, marriage, and a history of overseas residence (p<0.05). Of these factors, a history of overseas residence was a significant risk factor in a multivariate analysis (p<0.05). A total of 95 patients who were seronegative on their initial screen showed serial toxoplasma IgG antibodies (mean duration of follow-up, 2.1 years). Among these patients, only two (2.1%) acquired IgG antibodies to Toxoplasma gondii during the follow-up period.
CONCLUSIONS
The seroprevalence of anti-toxoplasma IgG antibodies in HIV-infected patients in Korea was 8.5%. A history of overseas residence was a significant risk factor for toxoplasma seropositivity. The incidence of TE was 0.34/100 py, which is lower than that reported in other countries. Toxoplasma seroconversion was also uncommon (2.1%).

Keyword

HIV; Toxoplasma gondii; Toxoplasmic encephalitis; Seroprevalence

MeSH Terms

Acquired Immunodeficiency Syndrome
Antibodies
Brain
Encephalitis
Follow-Up Studies
Heterosexuality
HIV
HIV Infections
Hospitals, University
Humans
Immunoglobulin G
Incidence
Korea
Marriage
Multivariate Analysis
Prevalence
Republic of Korea
Retrospective Studies
Risk Factors
Seroepidemiologic Studies
Toxoplasma
Antibodies
Immunoglobulin G