Is toxoplasmosis a potential risk factor for liver cirrhosis

Abstract 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 seropositivity 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% CI : 2.3–165.2; P  = 0.0008, OR  = 0.29; 95% CI : 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% CI : 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.