Chagas disease screening among HIV-positive Latin American immigrants: an emerging problem

Abstract

Chagas disease (CD) is an emergent disease in Europe that can behave as an opportunistic infection in HIV positive patients. The objective of this study was to evaluate the implementation of a CD screening programme in an HIV unit. An immunochromatography (ICT) of Trypanosoma cruzi was performed as a screening tool in HIV-positive patients born in CD endemic countries. ELISA and IFAT were used to confirm the diagnosis. A total of 155 patients, 116 males and 38 females, were included. Mean age was 36.9 years (± 8.4) and mean length of stay in Spain at the screening was 7.1 years (± 4.7). T. cruzi ICT was positive in four cases (2.6%), being confirmed (by ELISA and IFAT) in three of those (1.9%). Factors associated with confirmed positive T.cruzi serology were: Bolivia origin (p=0.016), Bolivia or Argentina origin (p=0.002), Southern Cone origin (p=0.015), rural origin (p=0.023), previously living in an adobe-made (p=0.001) or thatch-roofed house (p<0.0001), having a previous CD test (p=0.015), previous knowledge about CD (p=0.019), about vector (p=0.009) or recorded seeing vectors at home (p=0.012). Units dealing with HIV patients from endemic areas of American trypanosomiasis should implement CD screening protocols. Interviews of patients coming from endemic areas should include CD epidemiological questions.

Prevalence of Trypanosoma cruzi/HIV coinfection in southern Brazil

“…cruzi /HIV (5%), a rate 3.8-fold higher than the 1.3% estimate by the Ministry of Health in 2013. 11 Thus, the survey highlights T. cruzi as a potential opportunistic parasite in HIV patients from areas where Chagas disease is endemic, 16 such as southern Rio Grande do Sul, Brazil. A survey of HIV/ T. cruzi coinfection in Europe in patients from Bolivia, Argentina, or the Southern Cone, confirmed a 1.9% coinfection.…”

Benznidazole Treatment of Chagasic Encephalitis in Pregnant Woman with AIDS

“…In fact, the prevalence of T. cruzi infection among HIV-seropositive patients from disease-endemic regions was found to be 1.3% in Brazil and 1.9% in Spain ( 4 , 5 ). …”

Parasitosis importadas en la población inmigrante en España

“…Fue precisamente en nuestro país donde se describió el primer caso con desenlace fatal de enfermedad de Chagas agudo en Europa tras un trasplante de médula ósea 56 . Se describían también casos de co-infección en inmigrantes de áreas endémicas de enfermedad de Chagas con la infección por el VIH [57][58][59] . En cuanto a caracterización clínica, entre el 72 y el 81%, la infección crónica en la forma indetermi-nada fue el modo de presentación clínica, seguido de la afectación cardíaca (9,5-19%) y la digestiva (9-9,5%) 40,41,60 .…”