Contributions of molecular techniques in the chronic phase of Chagas disease in the absence of treatment

Sulleiro, Elena; Salvador, Fernando; Salazar, Pablo; Silgado, Aroa; Serre-Delcor, Núria; Oliveira, Inês; Moure, Zaira; Sánchez-Montalvà, Adrián; Aznar, María Luisa; Goterris, Lidia; Molina, Israel; Pumarola, Tomás

doi:10.1016/j.eimce.2020.06.002

Cited by 4 publications

(7 citation statements)

References 29 publications

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“…It has been suggested that patients in endemic regions are prone to parasite re-exposure, contributing to higher rates of CCC and parasitemia among patients with CD (45). In the same line, in a study performed in a non-endemic country, the positive PCR ratio decreased in patients with longer periods since the first arrival (8). Also, geographic distribution should play a role in CCC development and parasitemia burden.…”

Section: Discussionmentioning

confidence: 93%

“…Of the remaining 30 reports, we proceeded to a full-text review and finally included 10 articles. The characteristics of excluded studies are reported in Supplementary Material Appendix 3 (8,11,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). After checking the reference lists of these studies, we identified two additional eligible studies.…”

Section: Resultsmentioning

confidence: 99%

“…Current PCR-based methods for T. cruzi detection have shown high sensitivity and specificity compared with classical methods, such as blood culture or xenodiagnosis ( 8 ). However, sample collection, conservation, sample volume, DNA extraction method, and primers used may influence its performance ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

“…Besides the previously described factors, parasite dynamics in blood have not been thoroughly characterized. Intermittent parasitemia is constant in the chronic phase of CD but its periodicity, triggers, determinants, or reservoirs are still unknown ( 8 ). Thus, although the internal variability is probably acceptable among all studies as they used the same method throughout, lack of sensitivity could result in low positive ratios precluding differences detection.…”

Section: Discussionmentioning

confidence: 99%

“…However, parasite dynamics is still a matter of debate. While in the acute phase, the presence of T. cruzi in the blood is constant, in the chronic phase low level parasitemia is observed in a subset of patients ( 8 ). Different PCR assays have been developed to detect the parasite DNA with initial difficulties in standardizing techniques to obtain reliable and comparable results ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

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Association Between Trypanosoma cruzi DNA in Peripheral Blood and Chronic Chagasic Cardiomyopathy: A Systematic Review

Bosch-Nicolau

Espinosa-Pereiro

Salvador

et al. 2022

Front. Cardiovasc. Med.

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Chronic chagasic cardiomyopathy (CCC) is the most important complication of patients with Chagas disease (CD). The role of persistent detection of DNA in peripheral blood and its association to CCC is unknown. We performed a systematic review up to July 2021, including studies that reported ratios of CCC and PCR positivity among non-treated adult patients. We identified 749 records and selected 12 for inclusion corresponding to 1,686 patients. Eight studies were performed in endemic countries and 4 in non-endemic countries. Only two studies showed an association between CCC and Trypanosoma cruzi parasitemia by means of PCR detection. Six studies reported greater positive PCR ratios among patients with CCC than in the patients with indeterminate chagas disease (ICD) with no statistical significance. A significant risk of bias has been detected among most of the studies. Therefore, while we performed a meta-analysis, wide inter-study heterogeneity impeded its interpretation.ConclusionsWith the available information, we could not establish a correlation between PCR-detectable parasitemia and CCC.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020216072, identifier: CRD42020216072.

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Section: Discussionmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association Between Trypanosoma cruzi DNA in Peripheral Blood and Chronic Chagasic Cardiomyopathy: A Systematic Review

Bosch-Nicolau

Espinosa-Pereiro

Salvador

et al. 2022

Front. Cardiovasc. Med.

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What is the role of real time PCR in the follow up of patients with chronic Chagas’ disease?

Simón

Iborra

Carrilero

et al. 2020

Enfermedades Infecciosas y Microbiología Clínica

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Usefulness of polymerase chain reaction tests in Chagas disease studies

Bautista-Lopez,

Ndao

2024

Front. Parasitol.

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The Polymerase Chain Reaction (PCR) test is a highly sensitive, specific, and rapid diagnostic tool for Chagas disease. Chagas disease is caused by the protozoan flagellate Trypanosoma cruzi and is endemic to the Americas. While conventional serological methods are still used in the diagnosis of Chagas disease, they are being gradually replaced by molecular methods like PCR. PCR can detect the parasite’s DNA in blood or tissue samples from humans and animals, including asymptomatic infections and animal reservoirs. In a study conducted on a colony of New World monkeys, PCR analysis was found to be superior to conventional screening tools for trypanosome infection, although false negatives can still occur. In clinical studies, PCR has been used to assess the effectiveness of Nifurtimox and Benznidazole in treating acute and chronic Chagas patients. However, the presence of low-grade and intermittent parasitemia in peripheral blood, even in the absence of treatment, renders PCR an unreliable test for evaluating successful treatment. Based on this limiting factor, among others, we do not believe that PCR is an appropriate gold standard test for Chagas in clinical and preclinical studies. Other diagnostic methods, such as serological and biomarker tests, should be used in conjunction with PCR techniques for more accurate diagnosis of Chagas.

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Contributions of molecular techniques in the chronic phase of Chagas disease in the absence of treatment

Cited by 4 publications

References 29 publications

Association Between Trypanosoma cruzi DNA in Peripheral Blood and Chronic Chagasic Cardiomyopathy: A Systematic Review

Association Between Trypanosoma cruzi DNA in Peripheral Blood and Chronic Chagasic Cardiomyopathy: A Systematic Review

What is the role of real time PCR in the follow up of patients with chronic Chagas’ disease?

Usefulness of polymerase chain reaction tests in Chagas disease studies

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