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The poor clinical sensitivity of quantitative polymerase chain reaction (qPCR) for\n                      <jats:italic>Toxoplasma<\/jats:italic>\n                      in blood and CSF and the limited availability of molecular diagnostics and imaging technology leaves clinicians in resource-limited settings with few options other than empiric treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methology\/principle findings<\/jats:title>\n                    <jats:p>\n                      Here we describe proof of concept for a novel urine diagnostics for TE using Poly-N-Isopropylacrylamide nanoparticles dyed with Reactive Blue-221 to concentrate antigens, substantially increasing the limit of detection. After nanoparticle-concentration, a standard western blotting technique with a monoclonal antibody was used for antigen detection. Limit of detection was 7.8pg\/ml and 31.3pg\/ml of\n                      <jats:italic>T<\/jats:italic>\n                      .\n                      <jats:italic>gondii<\/jats:italic>\n                      antigens GRA1 and SAG1, respectively. To characterize this diagnostic approach, 164 hospitalized HIV-infected patients with neurological symptoms compatible with TE were tested for 1)\n                      <jats:italic>T<\/jats:italic>\n                      .\n                      <jats:italic>gondii<\/jats:italic>\n                      serology (121\/147, positive samples\/total samples tested), 2) qPCR in cerebrospinal fluid (11\/41), 3) qPCR in blood (10\/112), and 4) urinary GRA1 (30\/164) and SAG1 (12\/164). GRA1 appears to be superior to SAG1 for detection of TE antigens in urine. Fifty-one HIV-infected,\n                      <jats:italic>T<\/jats:italic>\n                      .\n                      <jats:italic>gondii<\/jats:italic>\n                      seropositive but asymptomatic persons all tested negative by nanoparticle western blot and blood qPCR, suggesting the test has good specificity for TE for both GRA1 and SAG1. In a subgroup of 44 patients, urine samples were assayed with mass spectrometry parallel-reaction-monitoring (PRM) for the presence of\n                      <jats:italic>T<\/jats:italic>\n                      .\n                      <jats:italic>gondii<\/jats:italic>\n                      antigens. PRM identified antigens in 8 samples, 6 of which were concordant with the urine diagnostic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusion\/significances<\/jats:title>\n                    <jats:p>Our results demonstrate nanoparticle technology\u2019s potential for a noninvasive diagnostic test for TE. Moving forward, GRA1 is a promising target for antigen based diagnostics for TE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0009199","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T13:51:59Z","timestamp":1614693119000},"page":"e0009199","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Detection of toxoplasmic encephalitis in HIV positive patients in urine with hydrogel nanoparticles"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3841-6154","authenticated-orcid":true,"given":"Hannah E.","family":"Steinberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4260-8009","authenticated-orcid":true,"given":"Natalie 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