Background: Toxoplasmosis is still a neglected common opportunistic infection in immunocompromised individuals, who are mainly people living with HIV (PLHIV) in whom reactivation of toxoplasmosis may occur with advanced
HIV conditions in resource-limited settings (RLS).
Objective: Our objective was to assess the correlation between anti-Toxoplasmic immunoglobulin G (anti-Toxo IgG) concentration and the immuno-virological status of PLHIV.
Methods: A cross-sectional study was conducted in 2018 among 100 PLHIV aged ≥18 years in Yaounde-Cameroon. For
each participant, anti-Toxo IgG, CD4-T lymphocytes, and plasma viral load (PVL) were measured using ELISA, flow cytometry, and real-time PCR respectively.
Results: Overall, 56% were seropositive for anti-Toxo IgG, when 33% were negative and 11% were equivocal. All (n=19)
those with PVL>1000 copies/mL were seropositive to anti-Toxo IgG versus 52.85% (37/70) with PVL<1000 copies/mL;
p<0.0001. Interestingly, all (n=11) those with severe immunodeficiency (T-CD4<200 cells/µL) were positive to anti-Toxo
IgG versus 57.69% (45/78) with T-CD4>200 cells/µL; p<0.0001. Most importantly, PVL and anti-Toxo IgG concentration
were positively correlated (r = 0.54; p<0.0001), while T-CD4 and anti-Toxo IgG concentration were negatively correlated
(r = - 0.70; p<0.0001). Adjusting age, gender, immune status and virological profile in logistic regression shows that only
immune status was independently associated to the serological status of toxoplasmosis (p=0.0004).
Conclusion: In Cameroon, about half of PLHIV might be seropositive to anti-Toxo IgG, with decreasing immunity appearing as risk of toxoplasmosis relapse. Thus, in the context of immunodeficiency, routine quantification of anti-Toxo IgG
would alleviate the programmatic burden of this opportunistic infection in RLS with generalized HIV epidemic.