Association Between Toxoplasma gondii Exposure and Heart Disease: A Case-Control Study

Cosme Alvarado-Esquivel, Misael Salcedo-Jaquez, Luis Francisco Sanchez-Anguiano, Jesus Hernandez-Tinoco, Elizabeth Rabago-Sanchez, Isabel Beristain-Garcia, Oliver Liesenfeld, Sergio Estrada-Martinez, Alma Rosa Perez-Alamos, Ediyair Alvarado-Soto


Background: The parasiteToxoplasma gondii causes infections all around the world. Infections withT. gondii are systemic and the parasite can persist in the heart muscle. Very little is known about the impact ofT. gondii on patients with heart disease. We determined the association betweenT. gondii exposure and patients suffering from heart diseases attending in a public hospital in Durango, Mexico; the association ofT. gondii exposure with socio-demographic, behavioral, and clinical characteristics of these patients was also investigated.

Methods: Through a case-control study, we examined the seroprevalence of anti-T. gondii IgG and IgM antibodies in 400 patients with heart diseases and 400 age- and gender-matched controls using enzyme-linked immunoassays. In addition, we analyzed the association of patient characteristics as determined by a standardized questionnaire withT. gondii exposure by bivariate and multivariate analyses.

Results: Fifty-five (13.8%) of 400 patients and 32 (8.0%) of 400 controls had anti-T. gondii IgG antibodies (odds ratio (OR) = 1.83; 95% confidence interval (CI): 1.15 - 2.90; P = 0.01). High anti-T. gondii IgG levels (> 150 IU/mL) were found in 28 (50.9%) of the 55 positive cases and in 14 (43.8%) of the 32 positive controls (P = 0.51). Anti-T. gondii IgM antibodies were found in 13 (23.6%) of the 55 anti-T. gondii IgG positive patients and in 19 (59.4%) of 32 anti-T. gondii IgG positive controls (OR = 0.21; 95% CI: 0.08 - 0.54; P = 0.0008). Multivariate analysis showed thatT. gondii exposure was positively associated with being born out of Durango State (OR = 2.93; 95% CI: 1.40 - 6.13; P = 0.004), and with consumption of alcohol (OR = 2.04; 95% CI: 1.01 - 4.12; P = 0.04).

Conclusions: Results obtained in this study indicate thatT. gondii infection is associated with heart disease, and suggest that heart disease might be related with a chronic infection. This is the first report of an association ofT. gondii exposure with alcohol consumption in this population. Results warrant for further research to determine the epidemiological impact ofT. gondii exposure on patients with heart diseases. Risk factors associated withT. gondii exposure are critical to design future prevention strategies againstT. gondii exposure.

J Clin Med Res. 2016;8(5):402-409


Toxoplasma gondii; Seroprevalence; Heart disease; Case-control study; Epidemiology; Alcohol

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