Toxoplasmosis in patients with chronic hepatitis C and patients with fatty liver

Document Type : Original Research

Authors
A. Dalimi
L. Hamidipour
F. Ghaffarifar
Faculty of Medical Sciences, Tarbiat Modares University
Abstract
Toxoplasma gondii can affect the human liver and cause pathological changes such as hepatomegaly, granuloma, hepatitis, necrosis and liver cirrhosis may result to chronic liver disease.

Objective: The aim in this study was to determine the rate of toxoplasmosis infection in chronic liver disease patients with HCV positive disease and in fatty liver patients.

Materials and Methods: This cross-sectional study was performed on 150 samples prepared from three groups, including individuals with hepatitis C, persons with grade 2 and higher fatty liver disease, and patients without liver complications as a control group during 1397 and 1398. Serum and whole blood were taken from each subject for ELISA and PCR study. Toxoplasma IgG kit was used for ELISA test and two pairs of specific primers were used to amplify T.gondii GRA6 gene in Nested-PCR.

Results: Out of 50 controls, only 3 (6%) showed positive chronic toxoplasmosis. Of 50 patients with HCV +, 21 (42%) and of 50 patients with fatty liver disease showed 17 (34%) infection with chronic toxoplasmosis. This difference in infection ratio was statistically significant (P <0.01). No positive sample was observed in the Nested-PCR test for detecting T.gondii.

Conclusion: The results of this study indicate an association between chronic toxoplasmosis and patients with hepatitis C and fatty liver. Therefore, toxoplasmosis could be assumed as a predisposing factor for the survival of chronic liver disease.

Keywords

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1. Alvarado-Esquivel C, Torres-Berumen JL, Estrada-Martinez S, Liesenfeld O, Mercado-Suarez MF. Toxoplasma gondii infection and liver disease: a case-control study in a northern Mexican population. Parasites & vectors. 2011;4:75.
2. Desmonts G, Remington JS. Direct agglutination test for diagnosis of Toxoplasma infection: method for increasing sensitivity and specificity. J Clin Microbiol. 1980;11:562–
3. Al-Henawy A. E.R, Abdel-Razik A., Zakaria S, Elhammady D., Saudy N., Azab M.S. Is toxoplasmosis a potential risk factor for liver cirrhosis? Asian Pac. J. Trop. Med. 2015, 8( 10): 784-791
4. Macri G, Sala M, Linder AM, Pettirossi N, Scarpulla M. Comparison of indirect fluorescent antibody test and modified agglutination test for detecting Toxoplasma gondii immunoglobulin G antibodies in dog and cat. Parasitol Res. 2009;105:35–40.
5. Lankarani KB, Ghaffarpasand F, Mahmoodi M, Lotfi M, Zamiri N, Heydari ST, et al. Non alcoholic fatty liver disease in Southern Iran: A population based study. Hepat Mon. 2013;13(5):e9248.
6. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011;34(3):274-85.
7. Montoya JG, Liesenfeld O: Toxoplasmosis. Lancet. 2004, 363: 1965-1976. 10.1016/S0140-6736(04)16412-X.
8. Nunura J, Vásquez T, Endo S, Salazar D, Rodriguez A, Pereyra S, Solis H: Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon. Rev Inst Med Trop Sao Paulo. 2010, 52: 107-110.
9. Ustun S, Aksoy U, Dagci H, Ersoz G: Incidence of toxoplasmosis in patients with cirrhosis. World J Gastroenterol. 2004, 10: 452-454.
10. Döşkaya M, Liang L, Jain A, Can H, Gülçe İz S, Felgner PL, et al. Discovery of new Toxoplasma gondii antigenic proteins using a high throughput protein microarray approach screening sera of murine model infected orally with oocysts and tissue cysts. Parasites & vectors. 2018;11(1):393-.
11. Abdoli A, Dalimi A, Soltanghoraee H, Ghaffarifar F. Molecular detection of Toxoplasma gondii in house sparrow (Passer domesticus) by LAMP and PCR methods in Tehran, Iran. J Parasit Dis 2016 40(4):1317–1321
12. Abdoli A, Dalimi A, Soltanghoraee H, Ghaffarifar F. Molecular Detection and Genotypic Characterization of Toxoplasma gondii in Paraffin-Embedded Fetoplacental Tissues of Women with Recurrent Spontaneous Abortion. Int J Fertil Steril. 2017;10(4):327-36.
13. Shen H, Lipka S, Kumar A, Mustacchia P. Association between nonalcoholic fatty liver disease and colorectal adenoma:a systemic review and meta–analysis. World J Gastrointest Oncol. 2014; 5(6):440.
14. Angulo P. GI epidemiology: nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2007; 25(8):883-9.
15. Fleischman MW, Budoff M, Ifran Zeeb DL,Foster T. NAFLD prevalence differs among Hispanic subgroups: the Multi – Ethnic study of Artherosclerosis. World J Gastroenterol. 2014; 20(17):4987.
16. Euroupean Association for the Study of the liver (EASL).EASL Recommendation on Treatment of Hepatitis C 2018. J Hepatol. 2018; 69(2):461-511. https://doi.org/10.1016/j.jhep.2018.03.026.
17. Mostafa El-Sayed N, Ramadan Ma, Ramadan Mo. Toxoplasma gondii Infection and Chronic Liver Diseases: Evidence of an Association. Trop Med Infec Dis. 2016; 1(1):7.
18. El-Shazly LB, El-Faramawy AA, El-Sayed NM, Ismail KA, Fouad SM. Intestinal parasitic infection among Egyptian children with chronic liver diseases. J Paras Dis. 2015; 39(1):7-12.
19. Al-Henawy A. E.R, Abdel-Razik A., Zakaria S, Elhammady D., Saudy N., Azab M.S. Is toxoplasmosis a potential risk factor for liver cirrhosis? Asian Pac J Trop Med. 2015, 8( 10): 784-791
20. El-Nahas H.A., El-Tantawy N.L, E Farag R., Alsalem A.MA. Toxoplasma gondii infection among chronic hepatitis C patients: A case-control study.. Asian Pac J Trop Med. 2014; 7(8): 589-593
21. Fazaeli A, Carter P , Darde M , Pennington T. Molecular typing of Toxoplsma gondii strains by GRA6 gene sequence analysis. Int J parasitol 2000;30(5):637-42
Pathobiology Reserach
Volume 23, Issue 4
June 2020
Pages 17-23