Chagas disease: criteria of cure and prognosis

Gontijo, Eliane Dias; Galvão, Lúcia Maria da Cunha; Elói-Santos, Silvana Maria

doi:10.1590/s0074-02761999000700069

Cited by 12 publications

(12 citation statements)

References 30 publications

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“…These results confirmed the persistence of the CS antibodies in the patients' sera for several years after treatment as previously shown (21,24,27,28). The hemoculture test presented a very high level of negative results from the first year after treatment, reaching 100% in the last year of follow-up.…”

Section: Discussionsupporting

confidence: 89%

“…The hemoculture test presented a very high level of negative results from the first year after treatment, reaching 100% in the last year of follow-up. However, this reduction cannot be considered a reliable indicator of cure, since it has a relatively low sensitivity, especially in treated patients where the benznidazole action leads to a rapid destruction of T. cruzi bloodstream trypomastigotes forms and is not efficient in all patients (21,24). It may therefore produce false-negative results in cases of low-level parasitemia, yielding inconclusive results posttreatment.…”

Section: Discussionmentioning

confidence: 99%

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Use of theTrypanosoma cruziRecombinant Complement Regulatory Protein To Evaluate Therapeutic Efficacy following Treatment of Chronic Chagasic Patients

Meira

Galvão²,

Gontijo

et al. 2004

J Clin Microbiol

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One of the greatest concerns in Chagas' disease is the absence of reliable methods for the evaluation of chemotherapy efficacy in treated patients. The tests available to evaluate cure after the specific treatment are the complement-mediated lysis (CoML) and flow cytometry tests, but they are not feasible for routine clinical use. In this study, we evaluated an enzyme-linked immunosorbent assay (ELISA) based on the recombinant Trypanosoma cruzi complement regulatory protein (rCRP) as a method to determine parasite clearance in comparison to the CoML and other methods such as conventional serology, hemoculture, and PCR in serum samples of 31 patients collected before and after the treatment, monitored for an average of 27.7 months after chemotherapy. The results showed that the percentage of patient samples that were positive by rCRP ELISA was reduced from 100 to 70.3, 62.5, 71.4, and 33.4% in the first, second, third, and fourth years after treatment, respectively, while the samples positive by CoML were reduced to 85.2, 81.2, 71.4, and 33.4% during the same period, demonstrating the same significant tendency in the reduction of positive samples. On the other hand, the conventional serology (CS) tests did not present this reduction. The percentage of samples positive by PCR was initially 77.4% and decreased to 55.5, 68.7, 47.7, and 50.0% at the fourth year after treatment, confirming the drastic clearance of circulating parasites after treatment. Our results strongly suggest that the rCRP ELISA was capable of detecting the early therapeutic efficacy in treated patients and confirmed its superiority over the CS tests and parasitologic methods.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Use of theTrypanosoma cruziRecombinant Complement Regulatory Protein To Evaluate Therapeutic Efficacy following Treatment of Chronic Chagasic Patients

Meira

Galvão²,

Gontijo

et al. 2004

J Clin Microbiol

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“…According to these criteria, the patients were considered cured (Gontijo et al 1999). The IC 50 values of the epimastigotes of these patients were 19 ± 4 µM (patients 22 and 36) and 35 ± 4 µM (patient 7) ( Table III).…”

Section: Resultsmentioning

confidence: 99%

“…While Chagas disease pathology is poorly understood, accumulating evidence indicates that parasite persistence within the target organs, in concert with an unbalanced immune response, plays a central role in the development of pathology in both the acute and chronic phases (WHO 2002). Accordingly, the prevailing opinion is that Chagas disease should be treated with anti-parasitic compounds (Gontijo et al 1999, WHO 2002.…”

Section: ± 1 µM Comparison Of Bz Susceptibility Of the Pre-treatmentmentioning

confidence: 99%

“…Currently, successful treatment is assessed by the disappearance of anti-T. cruzi antibodies (seroconversion), while therapeutic failure is assigned by the persistence of the parasite. Regrettably, serological markers may take up to 10 years to disappear and parasitological tests by haemoculture or xenodiagnosis have limited sensitivity (Gontijo et al 1999). An upcoming polymerase chain reaction (PCR)-based assay is a promising tool in the evaluation of parasitological cure, but it still presents limitations (Britto 2009).…”

Section: ± 1 µM Comparison Of Bz Susceptibility Of the Pre-treatmentmentioning

confidence: 99%

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Trypanosoma cruzi benznidazole susceptibility in vitro does not predict the therapeutic outcome of human Chagas disease

Moreno

D’Ávila²,

Silva

et al. 2010

Mem. Inst. Oswaldo Cruz

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Trypanocidal drugs for late stage, symptomatic Chagas disease (Trypanosoma cruzi infection)

Vallejo

Reyes

Garcia

et al. 2005

Cochrane Database of Systematic Reviews

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Chagas disease: criteria of cure and prognosis

Cited by 12 publications

References 30 publications

Use of theTrypanosoma cruziRecombinant Complement Regulatory Protein To Evaluate Therapeutic Efficacy following Treatment of Chronic Chagasic Patients

Use of theTrypanosoma cruziRecombinant Complement Regulatory Protein To Evaluate Therapeutic Efficacy following Treatment of Chronic Chagasic Patients

Trypanosoma cruzi benznidazole susceptibility in vitro does not predict the therapeutic outcome of human Chagas disease

Trypanocidal drugs for late stage, symptomatic Chagas disease (Trypanosoma cruzi infection)

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