Toxoplasma gondii infection as a potential risk for chronic liver diseases: A systematic review and meta-analysis

Microb Pathog. 2020 Dec:149:104578. doi: 10.1016/j.micpath.2020.104578. Epub 2020 Oct 16.


Toxoplasma gondii, the etiological agent of toxoplasmosis, can cause serious public health problems. Although Toxoplasma gondii tends more to neurotropic and ocular organs, some existing evidence suggest that this disease might induce serious pathological effects on liver. Hence, this study aimed to evaluate the relationship between chronic liver diseases and toxoplasmosis. Meanwhile, it attempted to assess whether patients with toxoplasmosis are susceptible to chronic liver diseases. To achieve this aim, the published studies related to the subject were systematically searched in five major electronic databases between the January 1, 1950 and October 1, 2019. The meta-analysis was carried out using the StatsDirect statistical software and a p-value less than 0.05 was considered significant for any test. Out of 691 identified studies, 10 studies met our inclusion criteria and entered this systematic review. The pooled prevalence rates of Toxoplasma gondii in patients with liver diseases (35.97%; 95% CI: 28.38-43.93) were higher than those in the control group (18.24%; 95% CI: 13.85-23.09). The meta-analysis indicated that the common Odd Ratio by a random effect model was 2.7 (95% CI: 2.30-3.24), revealing a significant association between chronic liver diseases and anti-Toxoplasma IgG antibody. The results of this systematic review confirmed the positive connection between toxoplasmosis and chronic liver diseases. Nonetheless, more studies are needed to clarify the detailed association between these diseases.

Keywords: Chronic liver diseases; Meta-analysis; Systematic review; Toxoplasma gondii; Toxoplasmosis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Antibodies, Protozoan
  • Humans
  • Liver Diseases* / complications
  • Liver Diseases* / epidemiology
  • Risk Factors
  • Seroepidemiologic Studies
  • Toxoplasma*
  • Toxoplasmosis* / complications
  • Toxoplasmosis* / epidemiology


  • Antibodies, Protozoan