{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:50:58Z","timestamp":1787017858273,"version":"build-2736575974"},"reference-count":114,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":162,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Cryptosporidium<\/jats:italic>\n                      spp. is a major opportunistic pathogens in HIV\/AIDS patients, contributing substantially to morbidity and mortality worldwide. Despite advances in HIV\/AIDS management, the global burden, genetic diversity, and risk factors of cryptosporidiosis in this high\u2010risk group remain incompletely understood.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic review and meta\u2010analysis of cross\u2010sectional and case\u2013control studies published between January 1, 2017, and June 10, 2025, in accordance with PRISMA 2020 guidelines. Literature searches were performed in PubMed, Scopus, Embase, and Web of Science, supplemented by Google Scholar. Eligible studies reported the prevalence of\n                      <jats:italic>Cryptosporidium<\/jats:italic>\n                      spp. in HIV\/AIDS patients, with or without comparison groups, using microscopy, serology, or molecular methods. Data extraction was performed independently by two reviewers, and study quality was assessed using the JBI checklist. Random\u2010effects models were applied in Comprehensive Meta\u2010Analysis software, with subgroup analyses and meta\u2010regression conducted to explore prevalence and heterogeneity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 89 studies were included. The pooled prevalence of\n                      <jats:italic>Cryptosporidium<\/jats:italic>\n                      spp. among HIV\/AIDS patients was 9.5% (95% CI: 7.6\u201311.8). Based on 17 case\u2013control studies, HIV\u2010positive individuals had a significantly higher risk of infection compared to HIV\u2010negative controls (OR: 3.5, 95% CI: 2.1\u20135.9). Subgroup analyses revealed higher pooled prevalence in smaller studies, medium\u2010HDI and lower\u2010middle\u2010income countries, and African and Central American settings. Pooled prevalence did not differ significantly across diagnostic methods. Among HIV\/AIDS patients positive for\n                      <jats:italic>Cryptosporidium<\/jats:italic>\n                      spp., 39.8% were aged \u2264\u200930\u2009years and 64.7% were &gt;\u200930\u2009years. Females represented 54.5% of positives, slightly higher than males at 45.8%. Most infected patients had CD4 counts \u2264\u2009200\u2009cells\/\u03bcL (62.5%), compared to 43.2% with counts &gt;\u2009200. Diarrhea was present in 78.4% of positive cases, versus 43.8% among those without infection. Meta\u2010regression confirmed a significant inverse association between sample size and prevalence (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.0019,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003). Molecular data identified diverse species and subtypes, with\n                      <jats:italic>C. hominis<\/jats:italic>\n                      and\n                      <jats:italic>C. parvum<\/jats:italic>\n                      predominating but zoonotic species such as\n                      <jats:italic>C. meleagridis<\/jats:italic>\n                      ,\n                      <jats:italic>C. felis<\/jats:italic>\n                      ,\n                      <jats:italic>C. viatorum<\/jats:italic>\n                      ,\n                      <jats:italic>C. canis<\/jats:italic>\n                      ,\n                      <jats:italic>C. suis<\/jats:italic>\n                      ,\n                      <jats:italic>C. andersoni<\/jats:italic>\n                      , and\n                      <jats:italic>C. cuniculus<\/jats:italic>\n                      also reported. Sensitivity analyses showed no single study significantly influenced the pooled prevalence. Funnel plot asymmetry and Egger\u2019s test indicated publication bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This updated synthesis demonstrates that cryptosporidiosis remains a substantial health burden in HIV\/AIDS patients, with notable genetic diversity reflecting both anthroponotic and zoonotic transmission routes. The strong association with immunosuppression, as evidenced by low CD4 counts and diarrheal symptoms, underscores its clinical relevance. These findings highlight the urgent need for improved surveillance, molecular epidemiology, and preventive interventions to mitigate the impact of\n                      <jats:italic>Cryptosporidium<\/jats:italic>\n                      spp. in vulnerable populations.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cjid\/2740716","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:43:06Z","timestamp":1781329386000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence, Genetic Diversity, and Risk Factors of\n                    <i>Cryptosporidium<\/i>\n                    spp. in HIV\/AIDS Patients: An Updated Systematic Review and Meta\u2010Analysis (2017\u20132025)"],"prefix":"10.1155","volume":"2026","author":[{"given":"Farzad","family":"Mahdavi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9262-0332","authenticated-orcid":false,"given":"Mohammad Reza","family":"Mohammadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayan","family":"Heidari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1293-3843","authenticated-orcid":false,"given":"Roumina","family":"Norouzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0185-2438","authenticated-orcid":false,"given":"Ali","family":"Pouryousef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kambiz","family":"Karimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Mousivand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahtab","family":"Mehboodi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4005-2687","authenticated-orcid":false,"given":"Ali","family":"Asghari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3409-984X","authenticated-orcid":false,"given":"Hassan","family":"Nourmohammadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2013.07.005"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1556\/1886.2019.00019"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.15.1.145-154.2002"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1590\/1519-6984.283306"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.2166\/wh.2023.094"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/vms3.70309"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms10122456"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/vms3.70040"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2018.08.018"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.2478\/s11686-020-00230-1"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12866-024-03273-w"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2021.08.007"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/ani11113307"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00087-19"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2021.1957097"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1051\/parasite\/2020025"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000054"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41182-022-00402-x"},{"key":"e_1_2_13_20_2","doi-asserted-by":"crossref","unstructured":"ObebeO. 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