Does a spontaneous cure for chagas' disease exist?

Abstract

Six Costa Rican Chagas' disease patients, with wellknown acute phase history and no specific treatment were examined in several occasions during 39, 24, 32, 16 and 14 years, respectively, from the onset. Nome of the patients presented heart abnormalities as revealed by the conventional EKG and ergometry, exceptfor one of them with an incomplete block of the right bundle branch. Also, no alterations of the oesophagus motility was detected manometrically except for another patient who presented a slight hypersensivity reaction to a pharmacological test (Mecholyl). Three out of six patients became serologically negative in 1981, remaining as such until 1986. Besides the conventional serology, the search of protective ("lytic") antibodies was also performed in 1985 and 1986, being completely negative in one of the "cured" patients and dubious in the other two. The hypothesis that these three patients had as spontaneous cure, based on the clinical, serological and parasitologica l findings is discussed.

New evidence of spontaneous cure in human Chagas' disease

“…As a general rule and considering a series of longitudinal studies, the most probable is that both factors have been involved in this evolution, since the patient certainly had an acute phase of HCD, in which myocytolysis and autonomic denervation generally occurs 1 2 5 10 20 . The basic difference between this case and the ones detected earlier in Costa Rica is just the present clinical picture, because those cases were in the chronic indeterminate form, with no cardiac and/or digestive detected disturbances 25 . Not only the age of the patients can explain this clinical difference, since the Costa Rican individuals were much younger than PER 5 25 .…”

“…However, spontaneous cure of HCD had never been detected before 1988, when Zeledón et al reported some cases that became serological and parasitologically negative without specific treatment three decades after their acute onset 25 Likewise, this possibility has been mentioned in Chile and Brazil but, in general, the authors consider that spontaneous cure must be understood as an exceptional situation in the natural history of HCD 52 13 20 25 . Similarly, another similar case was reported in Uruguay that was detected in 1998, during a routine international supervision of the National Chagas Disease Program in the city of Paysandu.…”

Bimodal distribution of Trypanosoma cruzi antibody levels in blood donors from a highly endemic area of Argentina: what is the significance of low‐reactive samples?

“…We hypothesize that these individuals have spontaneously cleared (or controlled) their T. cruzi infections and consequently are slowly seroreverting as antigenic stimulus to sustain high‐level seroreactivity is lost. Case reports of seroreversion in the absence of treatment were previously reported as well as seroreversion among untreated controls in benznidazole clinical trials …”

Reservoir host competence and the role of domestic and commensal hosts in the transmission of Trypanosoma cruzi

“…Under substantial risk levels, all surveyed dogs were seropositive to T. cruzi by the age of 4-5 years (Gürtler et al, 1996a(Gürtler et al, , 1986a suggesting little or no refractoriness to infection. Spontaneous serorecovery (i.e., reversal from seropositive to seronegative) was exceptionally reported in dogs (Castañera et al, 1998) and humans (Zeledón et al, 1988).…”