Exacerbation of HIV viral load simultaneous with asymptomatic reactivation of chronic Chagas' disease.

Sartori, Ana Marli Christovam; Caiaffa-Filho, Hélio H.; Bezerra, Rita Cristina; Guilherme, C.; Lopes, Marta Heloísa; Shikanai-Yasuda, Maria Aparecida

doi:10.4269/ajtmh.2002.67.521

Cited by 51 publications

(49 citation statements)

References 13 publications

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“…Patient 9 had erythrema nodosum but the reactivation of Chagas disease in patients 3 and 8 was only revealed as very high parasitaemias that were detectable by the microscopical examination of blood. Patient 3 had an history of progressive heart disease typical of chronic Chagas disease but showed no new symptoms or signs when his high parasitaemia developed (Sartori et al, 2002a). Patient 8, an asymptomatic woman with the indeterminate form of Chagas disease, gave birth to a baby with congenital T. cruzi infection 20 days before her high parasitaemia developed.…”

Section: Chagas Disease and Hiv Infectionmentioning

confidence: 96%

Manifestations of Chagas disease (American trypanosomiasis) in patients with HIV/AIDS

Sartori

Ibrahim

Braz³

et al. 2007

Annals of Tropical Medicine & Parasitology

184

220

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Between June 1989 and December 2005, an observational study of adults co-infected with HIV and Trypanosoma cruzi was conducted, to investigate the spectrum of manifestations of chronic Chagas disease (American trypanosomiasis) in the HIV-positive. The 31 men and 22 women investigated were aged 23-59 years. Each subject was investigated by ambulatory (Holter) and non-ambulatory electrocardiography, chest X-ray, oesophagography and echocardiography (to determine the clinical form of trypanosomiasis), by xenodiagnosis, blood culture and the microscopical examination of blood (to explore their T. cruzi parasitaemia), and by counting their CD4 T cells (to stage their HIV infection). The subjects were followed-up for 1-190 months (median = 58 months) and checked for re-activation of their Chagas disease, which was usually defined by the occurrence of unusual clinical manifestations and/or the detection, by microscopical examination, of trypanosomes in the blood or cerebrospinal fluid. Eleven (20.8%) of the subjects showed re-activation, another nine (17.0%) were found to have developed high T. cruzi parasitaemias but these were only detected by xenodiagnosis or culture, and 15 (28.3%) had illnesses typical of chronic Chagas disease in HIV-negative individuals, with low parasitaemias. Anti-T. cruzi therapy (benznidazole), recommended for 17 patients, resulted in the sustained reduction of parasitaemia in 11 of the 12 subjects who completed treatment. Chagas disease was the cause of death of eight of the 14 subjects who died during the study. Four of the women investigated gave birth, each to a single child, during follow-up, and three of the four babies showed evidence of the congenital transmission of T. cruzi.

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Section: Chagas Disease and Hiv Infectionmentioning

confidence: 96%

Manifestations of Chagas disease (American trypanosomiasis) in patients with HIV/AIDS

Sartori

Ibrahim

Braz³

et al. 2007

Annals of Tropical Medicine & Parasitology

184

220

View full text Add to dashboard Cite

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“…However, just as there are difficulties to know the exact number of individuals co-infected, this also occurs regarding the frequency that these reactivate the Chagas disease, a pathognomonic clinical event. However, when the parasitemia is analyzed by xenodiagnosis or blood culture, the co-infected individuals have a higher chagasic parasitemia than patients without the co-infection with the HIV, suggesting that this reactivation may occur asymptomatic, with a higher frequency 44,60,61 . In this revision, it was reported the occurrence of 41,2% of reactivations, this percentage higher than the ones related in series of cases, which varies between 10 and 15% 81,93,97 , reflecting that, probably, the more severe cases must have been diagnosed and related.…”

Section: Casesmentioning

confidence: 99%

Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010)

Almeida

Ramos

Correia

et al. 2011

Rev. Soc. Bras. Med. Trop.

Self Cite

114

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Introduction:The co-infection Trypanosoma cruzi/HIV has been described as a clinical event of great relevance. The objective of this study was to describe clinical and epidemiological aspects published in literature. Methods: It is a systematic review of a descriptive nature from the databases Medline, Lilacs, SciELO, Scopus, from 1980 to 2010. Results: There were 83 articles (2.8 articles/year) with a total of 291 cases. The co-infection was described in 1980 and this situation has become the defining AIDS clinical event in Brazil. This is the country with the highest number of publication (51.8%) followed by Argentina (27.7%). The majority of cases are amongst adult men (65.3%) native or from endemic regions with serological diagnosis in the chronic stage (97.9%) and indeterminate form (50.8%). Both diseases follow the normal course, but in 41% the reactivation of the Chagas disease occurs. The most severe form is the meningoencephalitis, with 100% of mortality without specific and early treatment of the T. cruzi. The medication of choice was the benznidazole on doses and duration normally used for the acute phase. The high parasitemia detected by direct or indirect quantitative methods indicated reactivation and its elevation is the most important predictive factor. The lower survival rate was related to the reactivation of the Chagas disease and the natural complications of both diseases. The role of the antiretroviral treatment on the co-infection cannot yet be defined by the knowledge currently existent. Conclusions: Despite the relevance of this clinical event there are still gaps to be filled.

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“…Reactivation of Chagas' disease may present as an opportunistic infection in individuals with AIDS/HIV (128) and in those undergoing immunosuppressive therapy for malignancies and in organ transplantation (8). When individuals with chronic and/or asymptomatic T. cruzi infection acquire HIV infection the reactivation of this infection (111) may present as a necrotizing encephalitis and/or acute myocarditis (63,102,109,110). Acute chagasic myocarditis may be the sole manifestation of reactivation, or it may accompany encephalitis.…”

Section: Trypanosoma Cruzi Infection and Adipose Tissuementioning

confidence: 99%

Adipocyte, Adipose Tissue, and Infectious Disease

Desruisseaux¹,

Nagajyothi²,

Trujillo³

et al. 2007

Infect Immun

121

109

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Exacerbation of HIV viral load simultaneous with asymptomatic reactivation of chronic Chagas' disease.

Abstract: Abstract. Chronic Trypanosoma cruzi infection can reactivate in patients with immunosuppression related to human immunodeficiency virus (HIV) infection, resulting in severe meningoencephalitis or myocarditis and high parasitemia.

Cited by 51 publications

References 13 publications

Manifestations of Chagas disease (American trypanosomiasis) in patients with HIV/AIDS

Manifestations of Chagas disease (American trypanosomiasis) in patients with HIV/AIDS

Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010)

Adipocyte, Adipose Tissue, and Infectious Disease

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