Chagas disease also known as American trypanosomiasis, is caused by Trypanosoma cruzi and transmitted by triatominae-contaminated feces. It is considered a neglected tropical disease that affects 6 to 7 million people worldwide. The reactivation of Chagas disease occurs when the chronically infected hosts are not able to control T. cruzi infection, generating recurrence of the acute phase. HIV is the main immunosuppressive infection that can lead to the reactivation of chronic Chagas disease in AIDS conditions. In co-infected patients, the reactivation of Chagas disease is related to their high parasite load, high HIV viral load, and CD4 T-cell counting less than 200/mm3, which may evolve to meningoencephalitis and myocarditis. Eight T. cruzi/HIV co-infected patients under antiretroviral therapy (ART) and ten Chagas disease patients without HIV infection that attended at Study Group of Chagas Disease, Hospital de Clínicas, University of Campinas (GEdoCh/HC/UNICAMP-SP) and Pontifical Catholic University of Campinas SP (PUCC/SP) were evaluated. Tests for Chagas disease were performed, such as qPCR and T. cruzi blood culture. The patient’s medical records were analyzed to verify clinical and epidemiological data, viral load, and CD4 T-cell counting since the outset of ART. For both groups, we found no statically significant differences between parasite load via blood culture and qPCR. In T. cruzi/HIV co-infected subjects, we observed a significant increase of CD4 T-cells counting and viral load decrease, which became undetectable over the years after ART. Parasites isolated from the patient’s blood culture were genotyped, being the majority of them infected with TcII and one case of mixed infection (TcII and TcV/TcVI). These results were expected according to the region of origin of the patients. We suggest that the parasite load be monitored through qPCR in T.cruzi/HIV co-infected patients. We conclude that ART in people living with HIV improves infection and immunosuppression control, enabling the natural evolution of the American trypanosomiasis.
Introduction: Acute Chagas disease involving reactivation can occur after organ transplant, and follow-up by direct parasitological or molecular methods is essential for monitoring the parasitic load in such patients. In contrast, there is a little data on the parasitic load in long-term organ recipients. In this study, we examined the parasitic load in long-term kidney transplant patients and assessed the possibility of late Chagas disease reactivation.
Methodology: Blood cultures and real-time PCR were used to assess the parasitic load in four immunosuppressed patients who underwent kidney transplants (between 1996 and 2014) and were also treated for parasites.
Results: There were no positive blood culture or real-time PCR results in Chagas disease patients who received kidney transplants. The real-time PCR presented detection limit of 0.1 parasite equivalent/mL. The time interval between the transplant and sample collection varied from one to 19 years.
Conclusions: No parasites were detected in the evaluated patients. The use of benznidazole and immunosuppressive therapy may have contributed to control the T. cruzi infection. In transplanted patients with Chagas disease, the use of methods such real-time PCR and blood culture can monitor the parasitic load and prevent disease reactivation.
The present paper aimed to characterize the bioactivity being exerted on Sclerotium rolfsii Sacc. in vitro by seed aqueous extracts from 64 yam bean (Pachyrhizus spp.) genotypes as well as their maceration times (0, 48 and 72 h). Three experiments were carried out following a completely randomized design with 64 treatments (potato-dextrose-agar PDA+extracts) with two controls (PDA with no extract and PDA+Cabrio® Top in the dose of 4 g/L) with four replicates with one Petri dish per experimental unit. The 64 treatments were adjusted in the dose of 0.1%. The mycelial growth diameter was assessed on the fifth day. Findings showed the diameters of macerating extracts to be 34.3 -67.0, 23.5 -57.8, and 37.5 -63.8 mm at 0, 48, and 72 h, respectively. PDA+Cabrio® Top and PDA with no extract controls ranged from 0.05 to 0.50 mm and 73.2 to 80.7 mm, respectively. P14, P1, P15, and P46 genotypes extracts achieved the lowest mean diameters (47 -48% shorter). P61 was the genotype bearing the largest mean diameter tantamount to a reduction of 21%. Therefore, every aqueous extract has shown to be active against S. rolfsii, which indicates that genotypes exerting higher toxicity should either be tested against other pathogens or used in the field macerating them for 48 h.
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