Seroepidemiology, clinical correlates, and GRA6-based genotyping of Toxoplasma gondii among immunocompromised patients in northeastern Iran.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
Toxoplasma gondii is a globally prevalent zoonotic protozoan and a significant cause of morbidity in immunocompromised individuals. Although toxoplasmosis is endemic in Iran, integrated serologic, clinical, and molecular data from northeastern regions are scarce. This cross-sectional study evaluated 1206 immunocompromised adults recruited from tertiary centers in Razavi Khorasan Province, Iran, including patients with HIV infection, liver transplant (LT), kidney transplant (KT), and hematopoietic cell transplantation (HCT), and malignancies under active treatment. Anti-T. gondii IgG/IgM antibodies and IgG avidity were assessed using ELISA. Recent infection was defined by low avidity, IgG seroconversion, or a > 2-fold increase in IgG titers. Patients with compatible clinical features and suggestive serology underwent PCR testing, and positive samples were genotyped using GRA6-based nested PCR and RFLP analysis. Demographic and exposure data were collected via structured questionnaires, and predictors of IgG seropositivity were identified using multivariable logistic regression. Overall, 46.0% of immunocompromised patients were IgG-seropositive, and 2.9% were IgM-positive, with recent infection detected in 2.9% of participants, primarily among HCT and LT recipients. Seropositivity was independently associated with rural residence, occupational animal exposure, household cat ownership, and consumption of undercooked meat. Clinically, mononucleosis-like illness, seizures, and pulmonary manifestations were more frequent among seropositive patients. GRA6 genotyping revealed a predominance of Type II strains, with occasional Type I and III lineages. These findings demonstrate a considerable burden of latent and recent T. gondii infection among immunocompromised patients in northeastern Iran, supporting the need for targeted screening and preventive strategies in high-risk populations.