為了解南台灣區域醫院中尿毒症接受規則血液透析者及人類免疫不全病毒感染陽性者弓蟲感染情形，分別選擇91名及34名病患和健康成人48名。利用ELISA套組試劑測試抗弓蟲免疫球蛋白G (IgG)及M (IgM)，173件血清檢體中共有21件檢體（12.1%）呈陽性反應。在91名尿毒症病人中，有11名（12.1%）呈弓蟲抗體IgG陽性，34名人類免疫不全病毒感染陽性者中，有9名（26.5%）呈IgG陽性，3名（8.8%）呈IgM陽性。經以ANOVA統計分析ELISA結果，發現尿毒症患者與其餘二組具有統計學上差異。陽性檢體再經西方墨點法檢查，顯示多數與弓蟲蟲體抗原分子量在30 kDa蛋白質呈陽性反應，在11名弓蟲抗體陽性之尿毒症病人血清中有8件（72.7%）呈陽性，9名人類免疫不全病毒感染者有4件（44.4%）呈陽性。經由血清學診斷發現人類免疫不全病毒感染陽性者中，弓蟲抗體陽性率較高，但尿毒症接受血液透析治療的病患，仍有潛伏弓蟲感染活化之危險。因此尿毒症病患及人類免疫不全病毒感染者，宜進行弓蟲抗體血清篩檢，持續追蹤，以便偵測出新近感染之病例。

In order to elucidate T. gondii infection in a regional hospital in southern Taiwan, serum samples were taken from 173 selected individuals. Among them, 91 serum samples were taken from uremic patients under regular hemodialysis, 34 from human immunodeficiency virus (HIV) infected patients and 48 from healthy adults. Of these 173 samples analyzed by commercial enzyme-linked immunosorbent assay (ELISA) kits including anti-T. gondii IgG and IgM, 21 were seropositive (12.1%) of T. gondii infection. Among 91 uremic patients, 11 (12.1%) were seropositive for IgG. Among 34 HIV-infected patients, 9 (26.5%) were seropositive for IgG and 3 (8.8%) were seropositive for IgM. ELISA data were tested by ANOVA and statistical significances were detected among these groups. The most common band revealed by Western blot assay was the 30 kDa antigen which appeared in 8 of 11 (72.7%) uremic IgG-positive patients and 4 of 9 (44.4%) HIV-infected patients. Serodiagnosis of T. gondii infection reveals a higher positive rate among HIV-infected patients, uremic patients under hemodialysis are also at risk for reactivation of latent toxoplasmal infection. Serological screening for anti-T. gondii antibodies among HIV-infected patients and hemodialytic patients as well as sustained follow-up to detect recent infection are extremely important.

Acknowledgement
中文摘要……………………………………………….….I
Abstract…………………………………………………...II
Table of contents……………………………………….…IV
List of tables and figures………………………………….V
Introduction………………………………………….….…1
Materials and Methods…………………………………….7
Results…………………………………………………….12
Discussion……………………………………………..….15
References………………………………………………...21

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