Serological profiles and evaluation of parasitaemia by PCR and blood culture in individuals chronically infected by Trypanosoma cruzi treated with benzonidazole

Trop Med Int Health. 2012 Mar;17(3):368-73. doi: 10.1111/j.1365-3156.2011.02936.x. Epub 2011 Dec 30.

Abstract

Objective: To evaluate the serological and parasitological status of patients with chronic Chagas disease (CD) after chemotherapy with benzonidazole.

Methods: Retrospective study of patients treated with benzonidazole (5 mg/kg/day for 60 days) between 1980 and 2010. Twenty-nine patients who had CD confirmed by two reagent immunological tests and/or one positive xenodiagnosis before treatment were included. Conventional serology (ELISA and IIF) and parasitological tests (haemoculture and N-PCR) were performed.

Results: At the time of treatment, the mean age of patients was 36 ± 7.24 years (20-39 years) and the time post-treatment varied from 1 to 29 years. After chemotherapy, all individuals had reagent ELISA and 93.1% had positive results for the IIF test. T. cruzi DNA was detected by N-PCR in 48.3%. Negative results were observed in 41.4% and inconclusive ones in 10.3%. Haemoculture was negative for all individuals.

Conclusions: Our results suggest that N-PCR may be useful in the early identification of therapeutic failure of CD. Although it is difficult to determine parasitological cure in negative N-PCR cases, we can infer that this condition represents a declination of parasitaemia as a favourable consequence of aetiological treatment.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Antibodies, Protozoan / blood
  • Antibodies, Protozoan / immunology
  • Chagas Disease / blood
  • Chagas Disease / drug therapy*
  • Chagas Disease / immunology
  • Chronic Disease
  • DNA, Protozoan / analysis*
  • Enzyme-Linked Immunosorbent Assay / methods
  • Female
  • Fluorescent Antibody Technique, Indirect / methods
  • Humans
  • Male
  • Nitroimidazoles / therapeutic use*
  • Parasitemia / blood
  • Parasitemia / drug therapy*
  • Parasitemia / immunology
  • Polymerase Chain Reaction / methods*
  • Polymerase Chain Reaction / standards
  • Retrospective Studies
  • Treatment Failure
  • Trypanocidal Agents / therapeutic use*
  • Trypanosoma cruzi / genetics*
  • Trypanosoma cruzi / immunology
  • Young Adult

Substances

  • Antibodies, Protozoan
  • DNA, Protozoan
  • Nitroimidazoles
  • Trypanocidal Agents
  • benzonidazole