scholarly journals Chagas Disease in People with HIV: A Narrative Review

2021 ◽  
Vol 6 (4) ◽  
pp. 198
Author(s):  
Eva H. Clark ◽  
Caryn Bern
Keyword(s):  
At Risk ◽  
Chagas Disease ◽  
South American ◽  
Appropriate Use ◽  
Hiv Diagnosis ◽  
Cd4 Counts ◽  
Virologic Control ◽  
Fatal Form ◽  
Chronic Chagas Disease ◽  
Cruzi Infection

Many questions remain unanswered regarding the epidemiology, pathophysiology, diagnosis, treatment, and monitoring of Trypanosoma cruzi infection in people with HIV (PWH). The reported prevalence of T. cruzi infection in PWH living in endemic countries ranges from 1–28% and is likely similar in at-risk US populations. While classic cardiac and gastrointestinal presentations of chronic Chagas disease occur in PWH, PWH are additionally at risk for a severe and often fatal form of T. cruzi-mediated disease called reactivation disease. T. cruzi reactivation typically occurs in PWH with low CD4 counts and poor virologic control. National HIV guidelines in several endemic South American countries recommend that all PWH be screened for T. cruzi infection at the time of HIV diagnosis; however, this recommendation is not widely implemented. The early detection of T. cruzi infection in PWH is critical as the sequelae of Chagas disease, including T. cruzi reactivation, may be preventable through the restoration of robust cellular immunity via the initiation of antiretroviral therapy and the appropriate use of antitrypanosomal therapy.

scholarly journals International meeting: new diagnostic tests are urgently needed to treat patients with Chagas disease

2008 ◽  
Vol 41 (3) ◽  
pp. 315-319 ◽  
Keyword(s):  
Chagas Disease ◽  
Diagnostic Tests ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Treatment Access ◽  
Limited Effectiveness ◽  
Technical Report ◽  
Blood Banks ◽  
Chronic Chagas Disease ◽  
Cruzi Infection

Trypanosoma cruzi infection is often not detected early on or actively diagnosed, partly because most infected individuals are either asymptomatic or oligosymptomatic. Moreover, in most places, neither blood banks nor healthcare units offer diagnostic confirmation or treatment access. By the time patients present clinical manifestations of advanced chronic Chagas disease, specific treatment with current drugs usually has limited effectiveness. Better-quality serological assays are urgently needed, especially rapid diagnostic tests for diagnosis patients in both acute and chronic phases, as well as for confirming that a parasitological cure has been achieved. Some new antigen combinations look promising and it is important to assess which ones are potentially the best, together with their requirements in terms of investigation and development. In August 2007, a group of specialized researchers and healthcare professionals met to discuss the state of Chagas infection diagnosis and to build a consensus for a plan of action to develop efficient, affordable, accessible and easy-to-use diagnostic tests for Chagas disease. This technical report presents the conclusions from that meeting.

scholarly journals Detection of anti-Trypanosoma cruzi antibodies by chimeric antigens in chronic Chagas disease-individuals from endemic South American countries

PLoS ONE ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. e0215623 ◽  
Author(s):  
Rodrigo Pimenta Del-Rei ◽  
Leonardo Maia Leony ◽  
Paola Alejandra Fiorani Celedon ◽  
Nilson Ivo Tonin Zanchin ◽  
Mitermayer Galvão dos Reis ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
South American ◽  
Chronic Chagas Disease

scholarly journals Rapid immunochromatographic tests for the diagnosis of chronic Chagas disease in at-risk populations: A systematic review and meta-analysis

2019 ◽  
Vol 13 (5) ◽  
pp. e0007271 ◽  
Author(s):  
Andrea Angheben ◽  
Dora Buonfrate ◽  
Mario Cruciani ◽  
Yves Jackson ◽  
Julio Alonso-Padilla ◽  
...  
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Chagas Disease ◽  
Meta Analysis ◽  
At Risk Populations ◽  
Chronic Chagas Disease

scholarly journals Comparison of seven diagnostic tests to detect Trypanosoma cruzi infection in patients in chronic phase of Chagas disease

2014 ◽  
pp. 61-66 ◽  
Author(s):  
Luisa Fernanda Duarte ◽  
Oscar Roberto Flórez ◽  
Giovanna Rincón ◽  
Clara Isabel González
Keyword(s):  
Comparative Analysis ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Diagnostic Tests ◽  
Nuclear Dna ◽  
Quality Analysis ◽  
Control Group ◽  
Predictive Values ◽  
Chronic Chagas Disease ◽  
Cruzi Infection

Objective: To compare the diagnostic performance of seven methods to determine Trypanosoma cruzi infection in patients with chronic Chagas disease. Methods: Analytical study, using the case-control design, which included 205 people (patients with Chagasic cardiomyopathy, n= 100; control group, n= 105). Three enzyme linked immunosorbent assays, one indirect hemagglutination assay and one immunochromatographic test were assessed. Additionally, DNA amplification was performed via the PCR method using kinetoplast and nuclear DNA as target sequences. For the comparative analysis of diagnostic tests, the parameters used were sensitivity, specificity, positive and negative predictive values, Receiver Operator Characteristic (ROC), positive and negative likelihood ratio, as well as κ quality analysis. Results: The commercial Bioelisa Chagas test showed the highest sensitivity (98%), specificity (100%), and positive and negative predictive values; additionally it had the highest discriminatory power. Otherwise, the amplification of T. cruzi DNA in blood samples showed low values of sensitivity (kinetoplast DNA= 51%, nuclear DNA= 22%), but high values of specificity (100%), and moderate to low discriminatory ability. Conclusion: The comparative analysis among the different methods suggests that the diagnostic strategy of T. cruzi infection in patients with chronic Chagas disease can be performed using ELISA assays based on recombinant proteins and/or synthetic peptides, which show higher diagnosis performance and can confirm and exclude the diagnosis of T. cruzi infection. The molecular methods show poor performance when used in the diagnosis of patients with chronic Chagas disease.

scholarly journals Evaluation of Chagas' disease transmission through breast-feeding

1988 ◽  
Vol 83 (1) ◽  
pp. 37-39 ◽  
Author(s):  
Achiléa L. Bittencourt ◽  
Moisés Sadigursky ◽  
Antusa A. da Silva ◽  
Carlos A. S. Menezes ◽  
Mércia M. M. Marianetti ◽  
...  
Keyword(s):  
Chagas Disease ◽  
Breast Feeding ◽  
Disease Transmission ◽  
Igg Antibodies ◽  
Direct Examination ◽  
Immunofluorescent Test ◽  
Indirect Immunofluorescent ◽  
Chronic Chagas Disease ◽  
Breast Fed ◽  
Cruzi Infection

On hundred milk or colostrum samples from 78 mothers with chronic Chagas' disease were parasitologically studied for Trypanosoma cruzi infection by means of direct examination and inoculation of mice. The mice were submitted to direct bllod examination three times a week. At the end of 45 days, xenodiagnosis and indirect immunofluorescent test (IFAT) for T. cruzi antibodies were carried out in the animals. No parasitized sample was observed even though five mothers had parasitemia at milk collection. In addition, 97 breast-fed children of chronic chagasic mothers, born free of infection, were tested for IgG antibodies to T. cruzi using IFAT. No case of T. cruzi infection was detected. The authors conclude that breast-feeding should not be avoided for children for chronic chagasic women. However, as these mothers had intermittent parasitemia, they should avoid nursing when there is nipple bleeding.

Chronic Chagas' Disease Cardiomyopathy Patients Display an Increased IFN-γ Response to Trypanosoma cruzi Infection

2001 ◽  
Vol 17 (1) ◽  
pp. 99-107 ◽  
Author(s):  
Lúcia C.J Abel ◽  
Luiz V Rizzo ◽  
Bárbara Ianni ◽  
Fabiana Albuquerque ◽  
Fernando Bacal ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Ifn Γ ◽  
Chronic Chagas Disease ◽  
Cruzi Infection

Dynamics of T Cells Repertoire During Trypanosoma cruzi Infection and its Post-Treatment Modulation

2019 ◽  
Vol 26 (36) ◽  
pp. 6519-6543 ◽  
Author(s):  
Adriana Egui ◽  
Paola Lasso ◽  
Elena Pérez-Antón ◽  
M. Carmen Thomas ◽  
Manuel Carlos López
Keyword(s):  
Immune Response ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Cardiac Tissue ◽  
Acute Infection ◽  
Clinical Status ◽  
Chronic Phase ◽  
Parasite Load ◽  
Chronic Patients ◽  
Cruzi Infection

Chagas disease courses with different clinical phases and has a variable clinical presentation and progression. The acute infection phase mostly exhibits a non-specific symptomatology. In the absence of treatment, the acute phase is followed by a chronic phase, which is initially asymptomatic. This chronic asymptomatic phase of the disease is characterized by a fragile balance between the host’s immune response and the parasite replication. The loss of this balance is crucial for the progression of the sickness. The virulence and tropism of the T. cruzi infecting strain together to the inflammation processes in the cardiac tissue are the main factors for the establishment and severity of the cardiomyopathy. The efficacy of treatment in chronic Chagas disease patients is controversial. However, several studies carried out in chronic patients demonstrated that antiparasitic treatment reduces parasite load in the bloodstream and leads to an improvement in the immune response against the Trypanosoma cruzi parasite. The present review is mainly focused on the cellular patterns associated to the clinical status and the evolution of the disease in chronic patients, as well as the effectiveness of the treatment related to T. cruzi infection control. Therefore, an emphasis is placed on the dynamics of specific-antigens T cell subpopulations, their memory and activation phenotypes, their functionality and their contribution to pathogenesis or disease control, as well as their association with risk of congenital transmission of the parasite.

Current Approaches to Drug Discovery for Chagas Disease: Methodological Advances

2019 ◽  
Vol 22 (8) ◽  
pp. 509-520
Author(s):  
Cauê B. Scarim ◽  
Chung M. Chin
Keyword(s):  
Drug Discovery ◽  
Chagas Disease ◽  
Drug Candidates ◽  
Lead Compounds ◽  
New Drug ◽  
Compound Libraries ◽  
Screening Assays ◽  
Cruzi Infection

Background: In recent years, there has been an improvement in the in vitro and in vivo methodology for the screening of anti-chagasic compounds. Millions of compounds can now have their activity evaluated (in large compound libraries) by means of high throughput in vitro screening assays. Objective: Current approaches to drug discovery for Chagas disease. Method: This review article examines the contribution of these methodological advances in medicinal chemistry in the last four years, focusing on Trypanosoma cruzi infection, obtained from the PubMed, Web of Science, and Scopus databases. Results: Here, we have shown that the promise is increasing each year for more lead compounds for the development of a new drug against Chagas disease. Conclusion: There is increased optimism among those working with the objective to find new drug candidates for optimal treatments against Chagas disease.

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