Toxoplasma Gondii IGG seroprevalence among individuals living with HIV: An 18-year single-center retrospective evaluation

BACKGROUND/AIM: Toxoplasma gondii is an important opportunistic pathogen in people living with HIV (PLWH), and the risk of reactivation increases markedly when CD4 counts fall below 100/mm³ . We aimed to determine T. gondii seroprevalence in PLWH, assess its associations with demographic and clinical variables, and emphasize preventive strategies for seronegative individuals. MATERIALS AND METHODS: This retrospective cohort study analyzed data from 1419 people living with HIV who were diagnosed by Western blot and followed at a tertiary care center between January 2006 and January 2024.Demographic characteristics, HIV RNA levels, CD4 counts, education level, probable route of HIV transmission, and T. gondii IgG/IgM results at the time of diagnosis were reviewed. Associations between categorical variables were evaluated using the chi-square test, and independent predictors were assessed using logistic regression analysis. RESULTS: Of the 1419 patients, 88.2% were male; the mean age was 45.7 years and the mean CD4 count was 302.6/mm³ . T. gondii IgG seropositivity was 41.1%. Seropositivity was significantly higher among patients aged ≥ 50 years and those with CD4 < 100/mm³ according to the chi-square test (p < 0.001). Heterosexual individuals had higher seropositivity, whereas men who have sex with men (MSM) were more often seronegative. Higher education level was significantly associated with seronegativity. CONCLUSION: This study, conducted in one of Türkiye's long-standing HIV care centers, provides comprehensive data on T. gondii seroprevalence among PLWH. The high seronegativity observed among younger and more educated individuals underscores the need for targeted education on hygiene and food safety. Regular screening and appropriate prophylactic strategies in seronegative patients at risk of advanced immunosuppression are critical to prevent life-threatening toxoplasmosis reactivation.