Is toxoplasmosis a potential risk factor for liver cirrhosis?
El-Henawy, A. A., Razik, A. A., Zakaria, S., Elhammady, D., Saudy, N., Azab, M. S.
Asian Pacific Journal of Tropical Medicine 2015; 8: 768-775
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Objective: To document Toxoplasma gondii (T. gondii) antibody status in patients with liver disease, blood samples were taken from 180 hepatic patients and 180 healthy controls. Methods: Toxoplasma IgG antibody was detected using enzyme-linked immunosorbent assay and histopathological assessment of liver biopsy METAVIR score was applied. Results: Anti-T. gondii IgG antibodies were found in 32.8% of patients and in 22.2% of controls (P=0.02). Toxoplasma scropositivity was significantly associated with lymphadenopathy, history of blood transfusion and reflex impairment in patients. Chronic hepatitis C virus (HCV) and chronic HCV-related cirrhosis groups compared to chronic HBV and chronic HBV-related cirrhosis groups expressed significantly higher prevalence of T. gondii seropositivity (odds ratio (OR) =4; 95% confidence interval (CI): 1.3-12.6; P=0.013, OR=4.8; 95% CI: 1.5-14.9; P=0.006, respectively). Within the chronic HCV group, T. gondii seropositivity significantly associated disease evolution as regards to METAVIR histopathological system for fibrosis and inflammation (OR=19.4; 95% Cl: 2.3-165.2; P=0.0008, OR=0.29; 95% Cl: 0.1-0.8; P=0.01, respectively). Albumin, international normalized ratio (INR) and platelets count were the laboratory parameters significantly altered in Toxoplasma-positive chronic HCV patients (P=0.001, 0.03, 0.04, respectively). Child-Pugh scoring for cirrhosis in chronic HCV group placed the majority of seropositive patient in class C with significant statistical difference compared to Child A reference group (OR=0.08; 95% Cl 0.01-0.5; P=0.003). Conclusions: Toxoplasma seropositivity was high in patients with cirrhosis and associated higher grades of inflammation and necrosis signifying disease evolution, suggesting that cirrhotic patients may thus form a risk group for toxoplasmosis