Malihe Nourollahpour Shiadeh1, Sahar Esfandyari2, Marzieh Ashrafmansouri3, Aliyar Mirzapour4, Ali Taghipour5, Adel Spotin6, Nasir Arefkhah7, Ray Gamble8, Amin Safa9, Ali Rostami10. 1. Sexual and Reproductive Health Research Centre, Mazandaran University of Medical Sciences, Sari, Iran. 2. Department of Physiology and Biophysics, Gollege of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA. 3. Diagnostic Laboratory Science and Technology Research Center, Faculty of Paramedical Science, Shiraz University of Medical Sciences, Shiraz, Iran. 4. Innovative Medical Research Center, Department of Medical Parasitology and Mycology, School of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran. 5. Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. 6. Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 7. Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran. 8. National Academy of Sciences, Washington, DC, USA. 9. Institute for Research and Development, Duy Tan University, Da Nang, 550000, Viet Nam; Department of Immunology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran. Electronic address: aminsafa@ucm.es. 10. Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. Electronic address: alirostami1984@gmail.com.
Abstract
OBJECTIVE: HIV in pregnancy is not only important for mother-to-child HIV transmission, but also it assumes additional importance because HIV increases susceptibility to opportunistic infections, leading to increased morbidity and mortality in mothers and neonates. Toxoplasmosis is one of the most important opportunistic infections in HIV-infected pregnant women. The present study was undertaken to assess the prevalence of latent toxoplasmosis (LT) and acute toxoplasmosis (AT) infection in HIV-infected pregnant women. METHODS: PubMed/MEDLINE, Scopus, Web of Science, EMBASE and SciELO were searched to identify relevant studies. A random-effects model was used to estimate the overall and subgroup-pooled prevalences across studies. Heterogeneity between studies was assessed via the I2 test. RESULTS: A total of 14 articles that included 3256 subjects in nine countries met the inclusion criteria. The overall prevalence rates of LT and AT in HIV-infected pregnant women were 45.7% (95% CI, 32.3-59.7%) and 1.1% (95% CI, 0.4-3.2%), respectively. The findings indicate that, worldwide, approximately 559,000 and 13,450 HIV-infected pregnant women are affected by LT and AT, respectively. From this review, it is estimated that approximately 3432 babies annually could be born with congenital toxoplasmosis (CT) from HIV-infected pregnant mothers. CONCLUSIONS: The present study indicates that a large number of HIV-infected mothers are affected by LT and AT. This can lead to adverse complications such toxoplasmic encephalitis in mothers and CT in neonates. Our results suggest a need for screening programs using well-validated diagnostic platforms for both LT and AT for all HIV-infected pregnant women.
OBJECTIVE: HIV in pregnancy is not only important for mother-to-child HIV transmission, but also it assumes additional importance because HIV increases susceptibility to opportunistic infections, leading to increased morbidity and mortality in mothers and neonates. Toxoplasmosis is one of the most important opportunistic infections in HIV-infected pregnant women. The present study was undertaken to assess the prevalence of latent toxoplasmosis (LT) and acute toxoplasmosis (AT) infection in HIV-infected pregnant women. METHODS: PubMed/MEDLINE, Scopus, Web of Science, EMBASE and SciELO were searched to identify relevant studies. A random-effects model was used to estimate the overall and subgroup-pooled prevalences across studies. Heterogeneity between studies was assessed via the I2 test. RESULTS: A total of 14 articles that included 3256 subjects in nine countries met the inclusion criteria. The overall prevalence rates of LT and AT in HIV-infected pregnant women were 45.7% (95% CI, 32.3-59.7%) and 1.1% (95% CI, 0.4-3.2%), respectively. The findings indicate that, worldwide, approximately 559,000 and 13,450 HIV-infected pregnant women are affected by LT and AT, respectively. From this review, it is estimated that approximately 3432 babies annually could be born with congenital toxoplasmosis (CT) from HIV-infected pregnant mothers. CONCLUSIONS: The present study indicates that a large number of HIV-infected mothers are affected by LT and AT. This can lead to adverse complications such toxoplasmic encephalitis in mothers and CT in neonates. Our results suggest a need for screening programs using well-validated diagnostic platforms for both LT and AT for all HIV-infected pregnant women.