Current status of Chagas disease chemotherapy

Abstract

Chagas disease affects 7.7 million people and 28 million people are at risk of acquiring the disease in 15 endemic countries of Latin America. Benznidazole and nifurtimox are drugs that have been used to treat the disease. However, both drugs induce severe side effects. Treatment with benznidazole has been recommended for the acute phase (0-4 months after infection), recent chronic phase (children 0-14 years of age, treated 4 months after infection) and congenital infection. Average cure rates for Chagas disease patients obtained from clinical trials were 97.9% (congenital infection, treatment performed 0-6 months of age), 71.5% (acute phase), 57.6% (recent chronic phase, children 0-13 years of age) and 5.9% (late chronic phase, great majority of patients between 15 and 69 years of age). Clinical evidence about the capacity of antiparasitic treatment to avoid, stop or revert heart pathology in indeterminate and cardiac chronic patients is contradictory. The investigation of novel therapeutic strategies against Chagas disease remains a priority in the research of tropical diseases. Unfortunately, Chagas disease remains neglected in the formulation of strategies toward control of this disease. This article focuses on current therapeutic approaches to Chagas disease.

Concomitant Benznidazole and Suramin Chemotherapy in Mice Infected with a Virulent Strain of Trypanosoma cruzi

“…While Sur has been recently indicated as a potential anti-T. cruzi drug (12,28), the applicability of Bz in the treatment of experimental and human Chagas disease is widely described (1,29,30). Since research and development of new specific medicines have been neglected for too many years, Bz remains the reference drug against T. cruzi infection.…”

“…ore than a century after its discovery, Chagas disease still represents a neglected parasitic infection responsible for the most common form of nonischemic cardiomyopathy worldwide (1,2), with 14,000 annual deaths induced by heart failure in South America (3). It is estimated that 8 to 10 million people are infected with Trypanosoma cruzi in Mexico and Central and South America, with 28 million remaining at risk of infection (3).…”

“…Although chemotherapy with Bz is not always successful, no drugs with therapeutic efficiency superior to that of Bz are available (5)(6)(7). Clinical studies have also reported marked side effects of Bz associated with low specificity and systemic toxicity (1,5). These limitations have highlighted the need for more effective and suitable strategies for Chagas disease control (1,7).…”

“…Clinical studies have also reported marked side effects of Bz associated with low specificity and systemic toxicity (1,5). These limitations have highlighted the need for more effective and suitable strategies for Chagas disease control (1,7).…”

Non, la maladie de Chagas n’est pas le nouveau sida des Amériques !

“…Les méta-analyses les plus récentes font état, à leur sujet, de résultats contradictoires et de toute manière beaucoup trop insuffisants pour recommander un traitement de tous les chagasiques chroniques [11,20,27]. L'une d'entre elles évalue même à 5,9 % seulement le taux de guérison parasitologique des patients âgés de 15 à 70 ans traités tardivement [13]. On est donc très loin de l'efficacité de la trithérapie antirétrovirale prescrite au cours du sida.…”