{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:31:08Z","timestamp":1777375868978,"version":"3.51.4"},"reference-count":52,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Evaluate prevalence, risk factors and outcomes of\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      infection and\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      disease among people with HIV living in southern Alberta over 37\u2009years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      People with HIV age \u226518\u2009years accessing care at the Southern Alberta Clinic (SAC) (Calgary, Alberta, Canada) between 01\/1\/1985 and 30\/06\/2022 with baseline\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      serology were included. Poisson regression models with robust variance (approximating log binomial models) estimated crude and adjusted prevalence ratios and 95% confidence intervals comparing risk factors for\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      seropositivity (vs. seronegativity). Cases of\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      disease were confirmed using laboratory and hospitalization data and evaluated using descriptive statistics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 4424 people with HIV, 3696 (84%) were\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      IgG negative and 728 (16%) IgG positive. In adjusted analyses,\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      seropositivity was associated with older age, birth outside of North America and lower educational attainment. The prevalence of\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      infection increased over time, associated with increased migration of people with HIV from\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      endemic regions.\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      disease was diagnosed among 36 people with HIV, the majority being male (72%), age &lt;50\u2009years (64%), born outside North America (72%) with a median CD4+ count of 33 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      at the time of\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      disease diagnosis. Recent HIV diagnosis and those re\u2010engaging in HIV care accounted for 16 cases. Five deaths from\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      disease occurred, and 17 experienced long\u2010term disability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      An increasing prevalence of\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      infection was identified among people with HIV at SAC likely due to increasing migration and age of the clinic population. The high mortality of\n                      <jats:italic>T.\u2009gondii<\/jats:italic>\n                      disease underscores the ongoing need for strategies to prevent infection and reactivation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70093","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T05:49:54Z","timestamp":1754372994000},"page":"1646-1656","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Changing prevalence and risk factors for\n                    <i>Toxoplasma gondii<\/i>\n                    seropositivity and disease in persons with\n                    <scp>HIV<\/scp>\n                    at the Southern Alberta Clinic since 1985"],"prefix":"10.1111","volume":"26","author":[{"given":"Charlotte","family":"Rosen","sequence":"first","affiliation":[{"name":"Department of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. John","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Southern Alberta Clinic Alberta Health Services  Calgary Alberta Canada"},{"name":"Department of Microbiology, Immunology &amp; Infectious Diseases University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4154-0145","authenticated-orcid":false,"given":"Esther","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4842-2846","authenticated-orcid":false,"given":"Hartmut","family":"Krentz","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Southern Alberta Clinic Alberta Health Services  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Kamaliddin","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology &amp; Infectious Diseases University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Department of Pathology and Laboratory Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Alberta Public Health Laboratory Alberta Health Services  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaqueline","family":"McMillan","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Department of Community Health Sciences University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda","family":"Beckthold","sequence":"additional","affiliation":[{"name":"Southern Alberta Clinic Alberta Health Services  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0268-4680","authenticated-orcid":false,"given":"Raynell","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Southern Alberta Clinic Alberta Health Services  Calgary Alberta Canada"},{"name":"Department of Community Health Sciences University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16412-X"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-69078-9"},{"issue":"4","key":"e_1_2_10_4_1","first-page":"898","article-title":"Global status of Toxoplasma gondii infection: systematic review and prevalence snapshots","volume":"36","author":"Molan A","year":"2019","journal-title":"Trop Biomed"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7519(00)00124-7"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2512.181565"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.14-0013"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.17-0677"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/154.4.357"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13071-016-1432-6"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/3284606"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw655"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2016.08.003"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/6634807"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199006000-00004"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13071-022-05398-1"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1984.03350070031018"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/15.2.211"},{"key":"e_1_2_10_19_1","unstructured":"EACS.E.A.C.S. EACS guidelines 2024 Part I: prevention & management of HIV & related infections.2024."},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1086\/344462"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir990"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1086\/424877"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003723"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26415"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3851\/IMP3287"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e31821b5332"},{"key":"e_1_2_10_27_1","unstructured":"NIH (N.I.o.H.).Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV.2024."},{"key":"e_1_2_10_28_1","volume-title":"International Migration in Alberta","author":"Alberta Treasury Board and Finance","year":"2009"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09015-7"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.11.4037-4044.2002"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1086\/593702"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/161.4.769"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198209093071107"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)11105-3"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.exppara.2009.03.013"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0212375"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.3102\/00346543075003417"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/6634807"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid0911.030143"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2021.02.007"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci10060369"},{"issue":"1883","key":"e_1_2_10_42_1","article-title":"Risky business: linking Toxoplasma gondii infection and entrepreneurship behaviours across individuals and countries","volume":"285","author":"Johnson SK","year":"2018","journal-title":"Proc Biol Sci"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-2-11"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-018-3427-z"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-007-9288-6"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1080\/00034983.1985.11811902"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pt.2013.01.007"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.exppara.2011.03.014"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30418-0"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2015.09.008"},{"issue":"1","key":"e_1_2_10_51_1","article-title":"SC\u201039 trends of Toxoplasma antibody prevalence in naive people living with HIV in Italy. Data from the ICONA cohort","volume":"100","author":"Bozzi G","year":"2024","journal-title":"Sex Transm Infect"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1080\/20477724.2022.2083977"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0258383"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T05:12:08Z","timestamp":1768194728000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,4]]},"references-count":52,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/hiv.70093"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70093","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,4]]},"assertion":[{"value":"2025-05-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}