Epidemiological-clinical profile and mortality in patients coinfected with Trypanosoma cruzi/HIV: experience from a Brazilian reference center

Abstract

study and take responsibility for the integrity of the data and the accuracy of the data analysis. AMH-M was responsible for the study concept. AMH-M, ASS, SSX, EPN, BGJG, FSNSM, and MFFM were responsible for acquisition, analysis or interpretation of data. AMH-M was responsible for drafting the manuscript. BGJG and MFFM were responsible for reviewing the manuscript. MFFM was responsible for statistical analysis. All authors have read and agreed to the published version of the manuscript.

Interesting case from Argentina: Kidney transplant recipient with skin lesions—A Latin American perspective

“…Quantitative PCR (qPCR) is usually used to evaluate the parasitic load, and an indirect parasitological test can also be used through quantitative xenodiagnosis, a method that requires a laboratory of greater operational complexity, which limits its use in clinical practice. 43,44 Histopathological methods may also be utilized to detect the parasite in tissue specimens. 41,45 For monitoring CCDR, real-time PCR is recommended due to its higher sensitivity in early detection compared to direct methods such as blood smear or concentration techniques (e.g., microhematocrit or the Strout method) commonly used in this context.…”

“…Direct examination allows us to see the circulating trypomastigote of T. cruzi , which confirms the diagnosis of reactivation. Quantitative PCR (qPCR) is usually used to evaluate the parasitic load, and an indirect parasitological test can also be used through quantitative xenodiagnosis, a method that requires a laboratory of greater operational complexity, which limits its use in clinical practice 43,44 . Histopathological methods may also be utilized to detect the parasite in tissue specimens 41,45 .…”

Quantitative PCR as a marker for preemptive therapy and its role in therapeutic control in Trypanosoma cruzi/HIV coinfection

“…Concerning T . cruzi /HIV-coinfected patients, a small number of treated non-reactivated patients and short follow-up periods have been recorded, so there is no conclusive data on the effectiveness of antiparasitic treatment [ 13 , 15 , 18 , 40 , 41 ]. Based on previous data [ 23 ], the Brazilian Guidelines on Chagas disease recommend treatment of HIV- coinfected patients with high parasitemia as Class IIa, level of evidence C [ 13 ], whereas the Brazilian Society of Cardiology recommends treatment of these cases as Conditional grade, level B [ 42 ].…”

“…Antiparasitic treatment is mandatory for acute Chagas disease and Chagas disease reactivation and has been recommended for all chronic Chagas disease patients under 50 years of age without severe cardiac or digestive impairment [13,[33][34][35][36][37][38][39]. Concerning T. cruzi/HIV-coinfected patients, a small number of treated non-reactivated patients and short follow-up periods have been recorded, so there is no conclusive data on the effectiveness of antiparasitic treatment [13,15,18,40,41]. Based on previous data [23], the Brazilian Guidelines on Chagas disease recommend treatment of HIV-coinfected patients with high parasitemia as Class IIa, level of evidence C [13], whereas the Brazilian Society of Cardiology recommends treatment of these cases as Conditional grade, level B [42].…”