Toxoplasmosis may present as a severe disease among some Egyptian patients with chronic liver disease (CLD) due to their impaired immune system, changing the course of the disease. The classical diagnosis of toxoplasmosis by serological tests is inadequate for such patients. This study was performed to highlight the role of real-time quantitative PCR (qrtPCR) test in the accurate diagnosis of toxoplasmosis among Egyptian patients with CLD. Seventy patients with CLD and 50 healthy controls were enrolled in this study. All were subjected to full clinical examinations, abdominal ultrasonography, and biochemical analysis of liver enzymes and they were investigated for markers of hepatitis B virus (HBV) and hepatitis C virus (HCV). In addition, Toxoplasma gondii (T. gondii) parasitemia was determined using qrtPCR. The results showed that T. gondii parasitemia was positive in 30% of CLD patients with highly statistically significant (p < 0.001) compared with the control group (6%). Co-infection in both T. gondii/HBV and T. gondii/HCV was 33.3% and 31.4%, respectively, with a highly significant association between T. gondii parasitemia and HCV viral load. Moreover, the results showed a significant increase of liver enzymes in the serum of patients positive for T. gondii compared with negative patients. An association between T. gondii infection and CLD was observed, and further studies will be needed to define the mechanism of this association.

Background: Toxoplasmosis is a significant health issue among Egyptian patients, exhibiting a high prevalence rate. Several studies have reported tuberculosis (TB)-Toxoplasma co-infection that could pose a double burden in healthcare facilities in developing countries. The present study aimed to study T. gondii seropositivity and IFN-γ levels among TB patients who had positive toxoplasmosis compared to those without toxoplasmosis and also identify the associated risk factors. Methods: Cross-sectional research on patients who attended the outpatient clinic at the chest hospital in Beni Suef Governorate, Egypt, from May 2023 to November 2023. Sputum samples were examined for TB positivity using Ziehl-Neelsen stain, Lowenstein Jensen culture and GeneXpert assay. Blood samples of TB patients screened for anti-Toxoplasma IgG/IgM antibodies, measuring interferon-gamma (IFN-γ) levels, and identifying the associated risk factors. Results: Out of 124 patients, 80 were TB positive and 44 were TB negative. Seropositivity of Toxoplasma infection was 51.25% (41/80) in TB-positive patients and 18.18% (8/44) in TB-negative patients, revealing a significant association between Toxoplasma positivity and TB (P<0.001). Statistical analysis indicated a significant association between Toxoplasma infection seropositivity in TB patients and the associated chronic diseases, taking immunosuppressive drugs, contacting pet animals, eating processed meat, washing hands and vegetables before eating and cooking meat well. Conclusion: The study findings showed Toxoplasma infection is prevalent amongst Egyptian TB patients. This gives insight into the importance of earlier identification and managing patients with TB-toxoplasmosis coinfection to avoid any serious complications.