Mother-child transmission of Chagas disease: could coinfection with human immunodeficiency virus increase the risk?

Abstract

A study was conducted on all newborns from mothers with Chagas disease who were attended at Hospital Donación F. Santojanni between January 1, 2001, and August 31, 2007. Each child was investigated for the presence of Trypanosoma cruzi parasitemia through direct examination of blood under the microscope using the buffy coat method on three occasions during the first six months of life. Serological tests were then performed. Ninetyfour children born to mothers infected with Trypanosoma cruzi were attended over the study period. Three of these children were born to mothers coinfected with the human immunodeficiency virus. Vertical transmission of Chagas disease was diagnosed in 13 children, in all cases by identifying parasitemia. The overall Chagas disease transmission rate was 13.8% (13/94). It was 100% (3/3) among the children born to mothers with HIV infection and 10.9% (10/91) among children born to mothers without HIV [Difference = 0.89; CI 95 = 0.82-0.95; p = 0.0021]. We concluded that coinfection with HIV could increase the risk of vertical transmission of Chagas disease.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…The importance of carrying out all the recommended evaluations during prenatal care, including anti-HIV testing is emphasized. The coinfection of T. cruzi and HIV in pregnant women increases the risk for congenital transmission of T. cruzi, by high parasitemia, also implying an increased morbidity and mortality (20) (116) (120) (123) (124) .…”

Mother-to-Child Transmission of Trypanosoma cruzi

“…A few small studies on HIV-T cruzi coinfection suggest HIV infection may dramatically increase the rate of congenital transmission [47,48]. Scapellato et al [47] report 100% congenital transmission of T cruzi among HIV-T cruzi coinfected mothers (n = 3) and 10.9% in mothers only infected with T cruzi (n = 91).…”

“…Scapellato et al [47] report 100% congenital transmission of T cruzi among HIV-T cruzi coinfected mothers (n = 3) and 10.9% in mothers only infected with T cruzi (n = 91). Larger studies are required to examine the role of maternal HIV infection on transmission of congenital T cruzi.…”

I Diretriz Latino-Americana para o Diagnóstico e Tratamento da Cardiopatia Chagásica

“…The most common clinical manifestation of reactivation is meningoencephalitis [363][364][365]367,369 . Myocarditis has been reported in 30%-40% of the cases [363][364][365]372 .…”

“…Chagas disease reactivation in HIV+ patients has high lethality 363,364,367 , which can reach 100% in untreated patients or those treated late. Early treatment is associated with better prognosis and a 20% reduction in lethality for patients completing 30 days of specific treatment.…”