Affiliation:
1. Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brasil
2. Fundação Oswaldo Cruz, Fiocruz Mato Grosso do Sul, Campo Grande, MS, Brasil
Abstract
Objective:
To evaluate parasitemia by qPCR in patients undergoing etiological treatment and followed in a Brazilian reference center.
Methods:
Parasite load was quantified by qPCR in 32 participants with chronic Chagas disease who were treated with benznidazole. Serological analyses were performed before and after the treatment and parasite loads were compared prior and 12/18 months post the treatment.
Results:
Thirty-two participants were recruited and treated with benznidazole, and 20 were followed-up. Adverse events (AE) were observed in 22 out of 29 participants that had safety data (76%), and dermatological alterations were the most frequently observed AE. Of the 20 participants analyzed, 13 and 7 completed 12 and 18 months follow-up after the treatment, respectively. 12 Months after the final treatment, Trypanosoma cruzi was detectable in 3 patients by qPCR; 18 months after the final treatment, Trypanosoma cruzi was detectable per qPCR in 4 of the 7 participants. Thus, between 12 and 18 months, 7 participants of the 20 initial follow-up cases showed positive qPCR, indicating treatment failures.
Conclusions:
qPCR can be used as an alternative method for evaluating the effectiveness of the etiological treatment of CD, and can be applied to analyze early therapeutic failures. The study showed that benznidazole therapy had limited effectiveness in treating chronic CD patients, thus emphasizing the importance of conducting continued research for developing more effective therapies and diagnosis for CD.
Reference29 articles.
1. II Consenso Brasileiro em Doença de Chagas, 2015. [Brazilian Consensus on Chagas Disease, 2015];Dias;Epidemiol Serv Saúde,2016
2. Chagas disease in Latin America: An epidemiological update based on 2010 estimates;World Health;Wkly Epidemiol Rec,2015
3. Endemic diseases: Globalization, urbanization, and immunosuppression;Shikanai-Yasuda;J Trop Med,2013
4. Towards a paradigm shift in the treatment of chronic Chagas disease;Viotti;Antimicrob Agents Chemother,2014
5. Randomized trial of benznidazole for chronic Chagas’ cardiomyopathy;Morillo;N Engl J Med,2015