EPIDEMIOLOGICAL SURVEILLANCE FOR TOXOPLASMOSIS AND CHAGAS DISEASE IN PEOPLE LIVING WITH HIV/AIDS (PLWHA)

Authors

  • Flavio Gonçalves Brito Universidade Estadual Paulista "Júlio de Mesquita Filho" – UNESP, Faculdade de Medicina de Botucatu - FMB, Botucatu, SP
  • Alexandre Naime Barbosa Universidade Estadual Paulista "Júlio de Mesquita Filho" – UNESP, Faculdade de Medicina de Botucatu -FMB, Botucatu, SP https://orcid.org/0000-0002-2187-4722
  • Rodrigo Costa da Silva Universidade do Oeste Paulista – UNOESTE, Presidente Prudente, SP https://orcid.org/0000-0001-9319-7516
  • Gismelli Cristiane Angeluci Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Faculdade de Medicina Veterinária e Zootecnia - FMVZ, Botucatu, SP https://orcid.org/0000-0001-6540-6050
  • Mariana Zancheta e Gava Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Faculdade de Medicina Veterinária e Zootecnia - FMVZ, Botucatu, SP
  • Benedito Donizete Menozzi Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Faculdade de Medicina Veterinária e Zootecnia - FMVZ, Botucatu, SP
  • Helio Langoni Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Faculdade de Medicina Veterinária e Zootecnia - FMVZ, Botucatu, SP https://orcid.org/0000-0001-5127-0762

DOI:

https://doi.org/10.35172/rvz.2023.v30.1558

Keywords:

immunosuppressed patients, anthropozoonoses, antibodies, risk factors

Abstract

The interest in the study of zoonoses, diseases common to humans and animals and related to single health, has increased markedly in recent years, requiring greater integration, knowledge and relationship between health professionals. Toxoplasmosis and Chagas disease (CD) are of high importance for public health, especially for people living with HIV/AIDS (PLWHA), as immunosuppression can aggravate the disease. The objective of this study was to determine the prevalence of these zoonoses in PLWHA treated at the Specialized Outpatient Service of Infectology "Domingos Alves Meira" (SAEI-DAM), of the Medical School of Botucatu, Unesp, and its association with risk factors related to both. Antibodies to Toxoplasma  gondii and Trypanosoma cruzi were investigated  in 236 samples of PLWHA serum, 154 (65%) were positive for T. gondii and 4 (1.69%) for T. cruzi. Twenty-one patients (8.89%) had neurotoxoplasmosis and six (2.54%) ocular toxoplasmosis. The high seroprevalence for toxoplasmosis may be a consequence of the close interaction with pets, especially cats, among other factors, concluding that the risk of clinical toxoplasmosis is high in the population studied due to the possibility of reactivation in immunocompromised patients, aggravated by the lack of information about the forms of infection and irregular use of ART found in the research. Given the results, it is believed that access to information, especially in those from rural areas, is a measure of great effectiveness in preventing exposure to toxoplasmosis, since higher seropositivity was associated with individuals with lower education and eating habits associated with the origin of animal products (meat and milk) and tap water intake. Educational campaigns that promote the development of attitudes and lifestyle can provide a reduction in morbidity and mortality in this at-risk population.

References

Langoni H, Vasconcelos CGC, Nitsche MJT, Olbrich SRLR, Carvalho LR, Silva RC. Fatores de risco para zoonoses em alunos do curso de medicina veterinária, residentes e pós-graduandos. Arq. Ciênc. Vet. Zool. UNIPAR. 2009;12(2):115-21.

Dubey JP, Lago EG, Gennari SM, Su C, Jones JL. Toxoplasmosis in humans and animals in Brazil: high prevalence, high burden of disease and epidemiology. Parasitology. 2012;139:1375–424. DOI: https://doi.org/10.1017/S0031182012000765

Howe DK, Sibley DL. Toxoplasma gondii Comprises Three Clonal Lineages: Correlation of Parasite Genotype with Human Disease. The Journal of Infec Dis. 1995; 172:1561-6. DOI: https://doi.org/10.1093/infdis/172.6.1561

Bahia-Oliveira LMG, Jones JL, Azevedo-Silva J, Alves CCF, Oréfice F, Addiss DG. Highly endemic, waterborne toxoplasmosis in north Rio de Janeiro State, Brazil. Emerging Infec Dis. 2003;9(1):55-62. DOI: https://doi.org/10.3201/eid0901.020160

Borguezan C, Sanches CFG, Oliveira JTM, Norberg PRBM, Uriarte MAA, Norberg AN. Seroprevalence of anti-Toxoplasma gondii antibodies among members of the Terena ethnic group, Mato Grosso do Sul, Brazil. Rev Cubana de Med Trop. 2014;66(1):48-57.

Inagaki ADM, Cardoso NP, Lopes RJPL, Alves JAB, Mesquita JRF, Araújo KCGM, et al. Análise espacial da prevalência de toxoplasmose em gestantes de Aracaju, Sergipe, Brasil. Rev Bras Ginecol Obstet. 2014;36(12):535–40. DOI:10.1590/SO100-720320140005086 DOI: https://doi.org/10.1590/So100-720320140005086

Reis MM, Tessaro MM, d’Azevedo PA. Perfil sorológico para toxoplasmose em gestantes de um hospital público de Porto Alegre. Rev Bras Ginecol Obstet. 2006;28(3):158-64. DOI: https://doi.org/10.1590/S0100-72032006000300004

Bowman DD, Lynn RC, Eberhard ML, Alcaraz A. Georgis’ Parasitology for Veterinarians. 8th. ed. São Paulo: Manole; 2006.

Luft BJ, Chua A†. Central Nervous System Toxoplasmosis in HIV Pathogenesis, Diagnosis, and Therapy. Curr Infec Dis Rep. 2000;2(4):358-62. DOI: https://doi.org/10.1007/s11908-000-0016-x

Gaspar G, Monereo A, Barros C, Castilla V, Gomez RJ, Sanz J, et al. Incidence of first episodes of HIV: opportunistic diseases and its changes over time in the period 1987 - 2001 in the COMESEM Cohort Study. In: Proceedings oh the 14h International AIDS Conference. Barcelona, Spain. July 7-12, 2001.

Kodym P, Malý M, Beran O, Jilich D, Rozsypal H, Machala L, et al. Incidence, immunological and clinical characteristics of reactivation of latent Toxoplasma gondii infection in HIV-infected patients. Epidemiol Infect. 2015;143:600-7. DOI:10.1017/S0950268814001253 DOI: https://doi.org/10.1017/S0950268814001253

Mateen FJ, Shinohara RT, Carone M, Miller EN, McArthur JC, Jacobson LP, et al. Neurologic disorders incidence in HIV+ vs HIV-men. Multicenter AIDS Cohort Study, 1996-2011. Neurology. 2012;79:1873-80. DOI: 10.1212/WNL.0b013e318271f7b8 DOI: https://doi.org/10.1212/WNL.0b013e318271f7b8

Maudlin I, Holmes PH, Miles MA. The Trypanosomiasis. 1st. ed. Trowbridge: Cabi; 2004. DOI: https://doi.org/10.1079/9780851994758.0000

Dias JCP. Notes about of Trypanosoma cruzi and yours bio-ecology characteristcs with agents of the transmission by meals. Rev Soc Bras Med Trop. 2006;39(4):370-75. DOI: https://doi.org/10.1590/S0037-86822006000400010

Rassi Jr A, Rassi A, Rezende JM. American Trypanosomiasis (Chagas Disease). Infect Dis Clin N Am. 2012;26:275-91. DOI:10.1016/j.idc.2012.03.002 DOI: https://doi.org/10.1016/j.idc.2012.03.002

Kieling C, Machado ARL. Doença de Chagas. In: Duncan BB, Schmidt MI, Giugliane ERJ. Medicina Ambulatorial: condutas de atenção primária baseadas em evidências. 3th. ed. Porto Alegre: Artmed; 2004.

Almeida EA, Ramos Júnior AN, Correia D, Shikanai-Yasuda MA. Co-infection Trypanosoma cruzi/HIV: systematic review (1980-2010). Rev Soc Bras Med Trop. 2011;44(6):762–70. DOI: https://doi.org/10.1590/S0037-86822011000600021

Pinazo MJ, Espinosa G, Cortes-Lletget C, Posada EJ, Aldasoro E, Oliveira I, et al. Immunosuppression and Chagas Disease: A Management Challenge. PLoS Negl Trop Dis. 2013;7(1):e1965. DOI:10.1371/journal.pntd.0001965 DOI: https://doi.org/10.1371/journal.pntd.0001965

Bern C. Chagas disease in the immunosuppressed host. Curr Opin Infect Dis. 2012;25(4):450-57. DOI:10.1097/QCO.0b013e328354f179 DOI: https://doi.org/10.1097/QCO.0b013e328354f179

Instituto Brasileiro de Geografia e Estatística - IBGE. Panorama do Censo 2022. Access on 15 ago 2023. Available from: https://censo2022.ibge.gov.br/panorama/

Hotez PJ, Dumonteil E, Woc-Colburn L, Serpa JA, Bezek S, Edwards MS, et al. Chagas disease: The new HIV/AIDS of the Americas. PLoS Negl Trop Dis. 2012;6(5): e1498. DOI:10.1371/journal.pntd.0001498 DOI: https://doi.org/10.1371/journal.pntd.0001498

Martins-Melo FR, Ramos Jr AN, Alencar CH, Heukelbach J. Mortality related to chagas disease and HIV/AIDS coinfection in Brazil. J Trop Med. 2012. DOI:10.1155/2012/534649 DOI: https://doi.org/10.1155/2012/534649

Almeida EA, Lima JN, Lages-Silva E, Guariento ME, Aoki FH, Torres-Morales AE, et al. Chagas’ disease and HIV co-infection in patients without effective antiretroviral therapy: prevalence, clinical presentation and natural history. Trans R Soc Trop Med Hyg. 2010;104:447–52. DOI: 10.1016/j.trstmh.2010.02.004 DOI: https://doi.org/10.1016/j.trstmh.2010.02.004

Stauffert D, Silveira MF, Mesenburg MA, Manta AB, Dutra AS, Bicca GLO, et al. Prevalence of Trypanosoma cruzi/HIV coinfection in southern Brazil. Braz J Infect Dis. 2017;21(2):180-84. DOI: 10.1016/j.bjid.2016.10.006 DOI: https://doi.org/10.1016/j.bjid.2016.10.006

Araújo AC, Rodrigues SC, Rezende AFS, Villela MM, Borsuk S. Soroprevalência de infecção humana por Trypanosoma cruzi em uma área rural do sul do Brasil. Rev Patol Trop. 2015;44(4):423-31. DOI: 10.5216/rpt.v44i4.39230 DOI: https://doi.org/10.5216/rpt.v44i4.39230

Dubey JP. Sources of Toxoplasma gondii infection in pregnancy: Until rates of congenital toxoplasmosis fall, control measures are essential. BMJ. 2000;321:127-28. DOI: https://doi.org/10.1136/bmj.321.7254.127

Olbrich Neto J, Meira DA. Seroprevalence of HTLV-I/II, HIV, siphylis and toxoplasmosis among pregnant women seen at Botucatu-São Paulo-Brazil. Risk factors for HTLV-I/II infection. Ver Soc Bras Med Trop. 2004;37:28-32. DOI: https://doi.org/10.1590/S0037-86822004000100008

Bhaskar R. Seronegative central nervous system toxoplasmosis in HIV/AIDS. J Intern Med. 2005;5(2):1-9. DOI: https://doi.org/10.5580/1f3d

Alvarado-Esquivel C, Pacheco-Vega SJ, Hernández-Tinoco J, Sánchez-Anguiano LF, Berumen-Segovia LO, Rodríguez FJI, et al. Seroprevalence of Toxoplasma gondii infection and associated risk factors in Huicholes in Mexico. Parasites & Vectors. 2014;7:301. DOI: https://doi.org/10.1186/1756-3305-7-301

Varella IS, Wagner MB, Darela AC, Nunes LM, Müller RW. Seroprevalence of toxoplasmosis in pregnant women. J Pediatr. 2003;79(1):69-74. DOI: https://doi.org/10.2223/JPED.940

Kawasaki ML, Carvalho PN, Lucarevschi BR. Toxoplasmosis care to deprived people during pregnancy in an inner city from São Paulo State. Pediatria. 2006;28(4):242-50.

Lopes FMR, Mitsuka-Breganó R, Gonçalves DD, Freire RL, Karigyo CJT, Wedy GF, et al. Factors associated with seropositivity for anti-Toxoplasma gondii antibodies in pregnant women of Londrina, Paraná, Brazil. Mem Inst Oswaldo Cruz. 2009;104(2): 378-82. DOI: https://doi.org/10.1590/S0074-02762009000200036

Garcia JL, Navarro IT. Levantamento soroepidemiológico da toxoplasmose em moradores da zona rural do município de Guaraci-Paraná-Brasil. Semina Ci. Agr. 1993;16(1):56-63. DOI: https://doi.org/10.5433/1679-0359.1995v16n1p63

Spalding SM, Amendoeira MRR, Klein CH, Ribeiro LC. Serological screening and toxoplasmosis exposure factors among pregnant women in South of Brazil. Med Trop. 2005;38(2):173-77. DOI: https://doi.org/10.1590/S0037-86822005000200009

Aramini JJ, Stephen C, Dubey JP. Toxoplasma gondii in Vancouver Island Cougars (Felis concolor vancouverensis): Serology and Oocyst Shedding. J Parasitol. 1998;84(2):438-40. DOI: https://doi.org/10.2307/3284508

Almeida MJ, Oliveira LHH, Freire RL, Navarro IT. Aspectos sociopolíticos da epidemia de toxoplasmose em Santa Isabel do Ivaí (PR). Ciência e Saúde Colet. 2011;16(Supl. 1):1363-373. DOI: https://doi.org/10.1590/S1413-81232011000700071

Avelino MM, Campos Júnior D, Parada JB, Castro AM. Risk Factors for Toxoplasma gondii Infection in Women of Childbearing Age. Braz J Infect Dis. 2004;8:164-74. DOI: https://doi.org/10.1590/S1413-86702004000200007

Dubey JP, Hill DE, Jones JL, Hightower AW, Kirkland E, Roberts JM, et al. Prevalence of viable Toxoplasma gondii in beef, chicken, and pork from retail meat stores in the United States: Risk assessment to consumers. J Parasitol. 2005;91(5):1082–93. DOI: https://doi.org/10.1645/GE-683.1

Hermes G, Ajioka JW, Kelly KA, Mui E, Roberts F, Kasza K, et al. Neurological and behavioral abnormalities, ventricular dilatation, altered cellular functions, inflammation, and neuronal injury in brains of mice due to common, persistent, parasitic infection. J Neuroinflam. 2008;5:48. DOI:10.1186/1742-2094-5-48 DOI: https://doi.org/10.1186/1742-2094-5-48

Alvarado-Esquivel C, Liesenfeld O, Burciaga-López BD, Ramos-Nevárez A, Estrada-Martínez S, Cerrillo-Soto SM, et al. Seroepidemiology of Toxoplasma gondii infection in Elderly People in a Northern Mexican City. Vector-Borne Zoonot Dis. 2012;12(7):568-74. DOI: 10.1089/vbz.2011.0875 DOI: https://doi.org/10.1089/vbz.2011.0875

Yohanes T, Debalke S, Zemene E. Latent Toxoplasma gondii Infection and Associated Risk Factors among HIV-Infected Individuals at Arba Minch Hospital, South Ethiopia. AIDS Res Treat. 2014. DOI: 10.1155/2014/652941 DOI: https://doi.org/10.1155/2014/652941

Tenter AM, Heckeroth AR, Weiss LM. Toxoplasma gondii: from animals to humans. Intern J Parasitol. 2000;30:1217-258. DOI: https://doi.org/10.1016/S0020-7519(00)00124-7

Rocha DS, Moura RLS, Maciel BM, Guimarães LA, O’dwyer HNS, Munhoz AD, et al. Detection of Toxoplasma gondii DNA in naturally infected sheep’s milk. Genet Molec Res. 2015; 14(3):8658-662. DOI: 10.4238/2015.July.31.14 DOI: https://doi.org/10.4238/2015.July.31.14

Camossi LG, Greca-Júnior H, Corrêa APFL, Richini-Pereira VB, Silva RC, Da Silva AV, et al. Detection of Toxoplasma gondii DNA in the milk of naturally infected ewes. Vet Parasitol. 2011;177:256-61. DOI:10.1016/j.vetpar.2010.12.007 DOI: https://doi.org/10.1016/j.vetpar.2010.12.007

Langoni H, Greca JÚNIOR H, Guimarães FF, Ullmann LS, Gaio FC, Uehara RS, et al. Serological profile of Toxoplasma gondii and Neospora caninum infection in commercial sheep from São Paulo State, Brazil. Vet Parasitol. 2011;177:50-54. DOI:10.1016/j.vetpar.2010.11.024 DOI: https://doi.org/10.1016/j.vetpar.2010.11.024

Holland GN, Engstrom Jr RE, Glasgow BJ, Berger BB, Daniels AS, Sidikaro Y, et al. Ocular Toxoplasmosis in Patients With the Acquired Immunodeficiency Syndrome. Am J Ophthalmol. 1988; 106(6):653-67. DOI: https://doi.org/10.1016/0002-9394(88)90697-6

Alves JS, Belo VS, Castro RC, Silva ES. Factors associated with soroprevalence of antibodies IgG e IgM anti-toxoplasma in HIV/AIDS patients assisted in an expert assistance service. J Health Biol Sci. 2016;4(3):145-151. DOI: 10.12662/2317-3076jhbs.v4i3.733.p145-151.2016 DOI: https://doi.org/10.12662/2317-3076jhbs.v4i3.733.p145-151.2016

Nunes CLX, Gonçalves LA, Silva PT, Bina JC. Características clinicoepidemiológicas de um grupo de mulheres com HIV/AIDS em Salvador-Bahia. Rev Soc Bras Med Trop. 2004;37(6):436-440. DOI: https://doi.org/10.1590/S0037-86822004000600002

Daryani A, Sharif M, Meigouni M. Seroprevalence of IgG and IgM anti-Toxoplasma antibodies in HIV/AIDS patients, northern Iran. Asian Pacific J Trop Med. 2011:271-274. DOI: https://doi.org/10.1016/S1995-7645(11)60084-9

Fernandes MA, Batista GI, Carlos JCS, Gomes IM, Azevedo KML, Setúbal S, et al. Toxoplasma gondii antibody profile in HIV-1-infected and uninfected pregnant women and the impact on congenital toxoplasmosis diagnosis in Rio de Janeiro, Brazil. The Brazil J Infect Dis. 2012;16(2):170-174. DOI: https://doi.org/10.1016/S1413-8670(12)70300-8

Mohraz M, Mehrkhani F, Jam S, SeyedAlinaghi S, Sabzvari D, Fattahi F, et al. Seroprevalence of Toxoplasmosis in HIV+/AIDS Patients in Iran. Acta Med Iran. 2011;49(4):213-218.

Del Rio-Chiriboga C, Orzechowski-Rallo A, Sanchez-Mejorada G. Toxoplasmosis of the central nervous system in patients with AIDS in Mexico. Arch Med Res. 1997;28(4):527-30.

Soares MT, Pinheiro JBF, Freitas CHSM, Smith AAF, Moreira EFR. Prevalência das Coinfecções em Pacientes Notificados com Aids no Centro de Referência na Paraíba. Rev Bras Ciênc Saúde. 2014;18(Supl.1):5-12. DOI: 10.4034/RBCS.2014.18.s1.01 DOI: https://doi.org/10.4034/RBCS.2014.18.s1.01

Xavier GA, Cademartori BG, Cunha Filho NA, Farias NAR. Evaluation of seroepidemiological toxoplasmosis in HIV/AIDS patients in South of Brazil. Rev Inst Med Trop São Paulo. 2013;55(1):25-30. DOI: 10.1590/S0036-46652013000100005 DOI: https://doi.org/10.1590/S0036-46652013000100005

Published

2023-12-13

How to Cite

1.
Gonçalves Brito F, Naime Barbosa A, Costa da Silva R, Angeluci GC, Zancheta e Gava M, Menozzi BD, Langoni H. EPIDEMIOLOGICAL SURVEILLANCE FOR TOXOPLASMOSIS AND CHAGAS DISEASE IN PEOPLE LIVING WITH HIV/AIDS (PLWHA). RVZ [Internet]. 2023 Dec. 13 [cited 2024 Nov. 24];30:1-23. Available from: https://rvz.emnuvens.com.br/rvz/article/view/1558

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