Toxoplasma Gondii Infection in HIV/AIDS: Prevalence and Risk Factors

BACKGROUND: Toxoplasmosis is an infection caused by the protozoan Toxoplasma gondii. It is common in severely immunecompromisedpersons.OBJECTIVE: To determine the seroprevalence of T. gondii infection and the risk factors associated with the infection and to investigate the association between T. gondii infection and CD4 cell count.METHODS: Sera collected from 242 HIV positive HAART- naive patients were tested for T. gondii specific immunoglobulin G antibodies. Information was obtained using a structured questionnaire. Baseline CD4 cell counts were obtained from patients case files. Data was managed using SPSS version 20 software and Microsoft Excel worksheet.RESULTS: One hundred and sixty eight (69.4%) subjects were females while 74(30.6%) were males. One hundred (41.3%) of study participants were Toxoplasma IgG antibody positive. Thirty two(32) HIV positive pregnant women were among this group studied with 12( 37.5%) being Toxo IgG antibody positive. Toxoplasma seropositivity was higher in females (42.8%) than in males (39.2%), P= 0.60. CD4 cell count level of < 200 was negatively associated with Toxoplasma seropositivity than CD4 count . 200 by logistic regression (OR= 0.6; 95% CI 0.3- 1.0). Living in proximity with cat was positively associated with T. gondii infection (P= 0.01).CONCLUSION: T. gondii infection is common in pregnant women indicating greater probability of congenital transmission of T. gondii. This could form a basis for recommending intensifying health education and prophylactic treatment for all HIV positive pregnant women. Measures should be taken to prevent stray cats from entering homes.Keywords: Toxoplasma gondii , IgG, Seroprevalence, HIV positive, CD4 cells

Selenium as adjunct to HAART in the management of HIV/Hepatitis B Virus coinfection: A Randomized open label study

Objective: Management of viral hepatitis in patients with HIV disease is quite challenging and  complex. With effective HIV treatment, people with HIV/HBV co-infection are living longer. HBV  epidemiologic surveys showed an inverse association between selenium (Se) level and regional cancer incidence, as well as viral infection. This study assessed effect of selenium as adjunct to HAART in management of HIV/HBV co-infection.Methods: A randomized open label study with participants allocated into three treatment groups: – HAART-only, Se-only and HAART-plus-Se. HIV viral load, HBV viral load, CD4 cell count, and alanine aminotransaminase (ALT), were analyzed at baseline and 18th month, analyzed using SPSS 5 v11. Ethical approval was obtained from Institute’s Ethical Review Board.Results: Sample size was 149 HIV/HBV patients. Rate of HBV clearance was higher among those on HAART-plus-Se at 18th month when compared with rate of clearance among those on HAART-only (p=0.046). CD4 count increment among HAARTplus- Se group compared with HAART-only group was higher (p=0.133), though not statistically significant. On comparison of baseline and 18th month ALT, there was significant decline for HAART-plus-Se (p=0.002) compared with HAART-only group.Conclusion: Selenium seems to have protective effect on liver cells; may be beneficial as adjunct to HAART in HIV/HBV management.Key words: HIV/HBV co-infection, Selenium adjunct, HAAR