Reactivation of Chagas' disease leading to the diagnosis of acquired immunodeficiency syndrome

Santos, Emanuele; Canela, João dos Reis; Monção, Henry Carlos Gomes; Roque, Mauro José Guedes

doi:10.1590/s1413-86702002000600009

Cited by 23 publications

(4 citation statements)

References 25 publications

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“…However, the utilized method was not specified in some articles 29,30,32,70 . Yet, the research between slide and cover slip of fresh material, thick smear with May-GrunwaldGiemsa coloration, Strout, microhematocrit and buffy-coat was reported in several studies in order to increase the sensitivity when verifying the presence of the protozoa 23,33,39,42,45,46,63,68,81 , not having, however, in any of those reference to the superiority of this methods compared to the study of the parasite directly on fresh material. The peripheral blood was the site where the parasite was most searched, but the liquor was where the largest proportion of positivity on the T. cruzi research (78%) occurred, which shows that it is indispensable the use of this evaluation during the investigation of cerebral impairment in patients with the co-infection, considering the feasibility of the exam.…”

Section: Casesmentioning

confidence: 99%

Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010)

Almeida

Ramos

Correia

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction:The co-infection Trypanosoma cruzi/HIV has been described as a clinical event of great relevance. The objective of this study was to describe clinical and epidemiological aspects published in literature. Methods: It is a systematic review of a descriptive nature from the databases Medline, Lilacs, SciELO, Scopus, from 1980 to 2010. Results: There were 83 articles (2.8 articles/year) with a total of 291 cases. The co-infection was described in 1980 and this situation has become the defining AIDS clinical event in Brazil. This is the country with the highest number of publication (51.8%) followed by Argentina (27.7%). The majority of cases are amongst adult men (65.3%) native or from endemic regions with serological diagnosis in the chronic stage (97.9%) and indeterminate form (50.8%). Both diseases follow the normal course, but in 41% the reactivation of the Chagas disease occurs. The most severe form is the meningoencephalitis, with 100% of mortality without specific and early treatment of the T. cruzi. The medication of choice was the benznidazole on doses and duration normally used for the acute phase. The high parasitemia detected by direct or indirect quantitative methods indicated reactivation and its elevation is the most important predictive factor. The lower survival rate was related to the reactivation of the Chagas disease and the natural complications of both diseases. The role of the antiretroviral treatment on the co-infection cannot yet be defined by the knowledge currently existent. Conclusions: Despite the relevance of this clinical event there are still gaps to be filled.

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Section: Casesmentioning

confidence: 99%

Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010)

Almeida

Ramos

Correia

et al. 2011

Rev. Soc. Bras. Med. Trop.

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“…Reactivation of chronic indeterminate Chagas disease in patients with HIV infection represents a serious event with high case fatality rates [1, 3, 4]. New aspects of the immunopathology of Chagas disease have been described recently in patients infected with HIV, and unusual clinical manifestations such as skin lesions, involvement of the central nervous system (meningoencephalitis), and/or serious heart damage (myocarditis) related to the reactivation of the disease have been reported [2–4]. …”

Section: Introductionmentioning

confidence: 99%

Mortality Related to Chagas Disease and HIV/AIDS Coinfection in Brazil

Martins-Melo

Ramos

Alencar

et al. 2012

Journal of Tropical Medicine

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Chagas disease in patients with HIV infection represents a potentially serious event with high case fatality rates. This study describes epidemiological and clinical aspects of deaths related to Chagas disease and HIV/AIDS coinfection in Brazil, 1999–2007. We performed a descriptive study based on mortality data from the nationwide Mortality Information System. Of a total of about 9 million deaths, Chagas disease and HIV/AIDS were mentioned in the same death certificate in 74 cases. AIDS was an underlying cause in 77.0% (57) and Chagas disease in 17.6% (13). Males (51.4%), white skin color (50%), age group 40–49 years (29.7%), and residents in the Southeast region (75.7%) were most common. Mean age at death was significantly lower in the coinfected (47.1 years [SD ± 14.6]), as compared to Chagas disease deaths (64.1 years [SD ± 14.7], P < 0.001). Considering the lack of data on morbidity related to Chagas disease and AIDS coinfection, the use of mortality data may be an appropriate sentinel approach to monitor the occurrence of this association. Due to the epidemiological transition in Brazil, chronic Chagas disease and HIV/AIDS coinfection will be further complicated and require the development of evidence-based preventive control measures.

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“…The central nervous system (CNS) is adversely affected in about 79% of subjects co-infected with T. cruzi and HIV (Jesus et al, 1995;Ferreira et al, 1997;Cohen et al, 1998;Pacheco et al, 1998;Araú jo Filho et al, 1999;Galhardo et al, 1999;Pagano et al, 1999;Santos et al, 1999;Silva et al, 1999;Lages-Silva et al, 2002;Santos et al, 2002;Madalasso et al, 2004;Vaidian et al, 2004;Yoo et al, 2004). Myocarditis, the second most common manifestation of re-activation in the HIVpositive, occurs in about 25% of co-infected patients (Sartori et al, 1995(Sartori et al, , 1998aFerreira et al, 1997;Galhardo et al, 1999;Rivera et al, 2004;Vaidian et al, 2004).…”

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Manifestations of Chagas disease (American trypanosomiasis) in patients with HIV/AIDS

Sartori

Ibrahim

Braz³

et al. 2007

Annals of Tropical Medicine & Parasitology

184

220

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Between June 1989 and December 2005, an observational study of adults co-infected with HIV and Trypanosoma cruzi was conducted, to investigate the spectrum of manifestations of chronic Chagas disease (American trypanosomiasis) in the HIV-positive. The 31 men and 22 women investigated were aged 23-59 years. Each subject was investigated by ambulatory (Holter) and non-ambulatory electrocardiography, chest X-ray, oesophagography and echocardiography (to determine the clinical form of trypanosomiasis), by xenodiagnosis, blood culture and the microscopical examination of blood (to explore their T. cruzi parasitaemia), and by counting their CD4 T cells (to stage their HIV infection). The subjects were followed-up for 1-190 months (median = 58 months) and checked for re-activation of their Chagas disease, which was usually defined by the occurrence of unusual clinical manifestations and/or the detection, by microscopical examination, of trypanosomes in the blood or cerebrospinal fluid. Eleven (20.8%) of the subjects showed re-activation, another nine (17.0%) were found to have developed high T. cruzi parasitaemias but these were only detected by xenodiagnosis or culture, and 15 (28.3%) had illnesses typical of chronic Chagas disease in HIV-negative individuals, with low parasitaemias. Anti-T. cruzi therapy (benznidazole), recommended for 17 patients, resulted in the sustained reduction of parasitaemia in 11 of the 12 subjects who completed treatment. Chagas disease was the cause of death of eight of the 14 subjects who died during the study. Four of the women investigated gave birth, each to a single child, during follow-up, and three of the four babies showed evidence of the congenital transmission of T. cruzi.

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Reactivation of Chagas' disease leading to the diagnosis of acquired immunodeficiency syndrome

Cited by 23 publications

References 25 publications

Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010)

Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010)

Mortality Related to Chagas Disease and HIV/AIDS Coinfection in Brazil

Manifestations of Chagas disease (American trypanosomiasis) in patients with HIV/AIDS

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