Unveiling the Hidden Burden of TORCH Infections in HIV Patients: A Residual Serum Seroepidemiological Study in a Korean Metropolitan City

다국어 초록 (Multilingual Abstract)

Background Although human immunodeficiency virus (HIV) is a legally notifiable disease in Korea, surveillance data are reported in aggregate without regional breakdowns. This limits the ability of local governments to design targeted prevention and care strategies. The coronavirus disease 2019 pandemic underscored the importance of region-specific epidemiological data for timely public health responses. TORCH infections—comprising Toxoplasma gondii, Treponema pallidum, rubella virus, cytomegalovirus (CMV), and herpes simplex virus (HSV)—can cause severe complications in immunocompromised individuals, including those with HIV. Despite the clinical significance, no previous Korean study has comprehensively assessed the seroprevalence of TORCH infections among HIV-infected adults at the metropolitan level. This study aimed to investigate TORCH seroprevalence using residual serum from HIV-confirmed individuals tested at the Incheon Metropolitan City Research Institute of Public Health and Environment.


Materials and Methods Residual serum samples from 100 HIV-positive individuals, confirmed by the Incheon Metropolitan City Institute of Public Health and Environment between 2019 and 2021, were tested for IgG and IgM antibodies against T. gondii, T. pallidum, rubella, CMV, and HSV types 1 and 2 using enzyme-linked immunosorbent assay. A control group of 100 HIV-negative serum from the same period was analyzed for comparison. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate associations.


Results HIV-positive individuals demonstrated significantly higher IgG seropositivity for T. gondii (11.1% vs. 3.0%, OR, 3.97, P=0.046), T. pallidum (29.0% vs. 1.0%, OR, 39.92, P<0.001), CMV (99.0% vs. 78.0%, OR, 27.60, P<0.001), HSV-1 (96.0% vs. 87.0%, OR, 3.56, P=0.039), and HSV-2 (89.0% vs. 69.0%, OR, 3.61, P<0.001). No significant differences were observed for rubella IgG or any IgM antibodies.


Conclusion This is the first metropolitan-level seroepidemiological study in Korea to examine TORCH infections among HIV-positive adults. The markedly higher prevalence of certain TORCH pathogens in the HIV group highlights the urgent need for routine screening and targeted prevention strategies, particularly at the local government level where patient care and resource allocation are managed. These findings provide a essential evidence base for Incheon and may inform similar initiatives in other regions, strengthening both clinical management and public health policy for HIV-infected populations. the results underscore the importance of establishing periodic surveillance systems to monitor temporal trends and enable timely public health interventions.

다국어 초록 (Multilingual Abstract)

Background Although human immunodeficiency virus (HIV) is a legally notifiable disease in Korea, surveillance data are reported in aggregate without regional breakdowns. This limits the ability of local governments to design targeted prevention and care strategies. The coronavirus disease 2019 pandemic underscored the importance of region-specific epidemiological data for timely public health responses. TORCH infections—comprising Toxoplasma gondii, Treponema pallidum, rubella virus, cytomegalovirus (CMV), and herpes simplex virus (HSV)—can cause severe complications in immunocompromised individuals, including those with HIV. Despite the clinical significance, no previous Korean study has comprehensively assessed the seroprevalence of TORCH infections among HIV-infected adults at the metropolitan level. This study aimed to investigate TORCH seroprevalence using residual serum from HIV-confirmed individuals tested at the Incheon Metropolitan City Research Institute of Public Health and Environment.




Materials and Methods Residual serum samples from 100 HIV-positive individuals, confirmed by the Incheon Metropolitan City Institute of Public Health and Environment between 2019 and 2021, were tested for IgG and IgM antibodies against T. gondii, T. pallidum, rubella, CMV, and HSV types 1 and 2 using enzyme-linked immunosorbent assay. A control group of 100 HIV-negative serum from the same period was analyzed for comparison. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate associations.




Results HIV-positive individuals demonstrated significantly higher IgG seropositivity for T. gondii (11.1% vs. 3.0%, OR, 3.97, P=0.046), T. pallidum (29.0% vs. 1.0%, OR, 39.92, P<0.001), CMV (99.0% vs. 78.0%, OR, 27.60, P<0.001), HSV-1 (96.0% vs. 87.0%, OR, 3.56, P=0.039), and HSV-2 (89.0% vs. 69.0%, OR, 3.61, P<0.001). No significant differences were observed for rubella IgG or any IgM antibodies.




Conclusion This is the first metropolitan-level seroepidemiological study in Korea to examine TORCH infections among HIV-positive adults. The markedly higher prevalence of certain TORCH pathogens in the HIV group highlights the urgent need for routine screening and targeted prevention strategies, particularly at the local government level where patient care and resource allocation are managed. These findings provide a essential evidence base for Incheon and may inform similar initiatives in other regions, strengthening both clinical management and public health policy for HIV-infected populations. the results underscore the importance of establishing periodic surveillance systems to monitor temporal trends and enable timely public health interventions.