High seroconversion rates in Trypanosoma cruzi chronic infection treated with benznidazole in people under 16 years in Guatemala

Abstract

Introduction: Geographical, epidemiological, and environmental differences associated with therapeutic response to Chagas etiological treatment have been previously discussed. This study describes high seroconversion rates 72 months after benznidazole treatment in patients under 16 years from a project implemented by Doctors without Borders in Guatemala. Methods: An enzyme-linked immunosorbent assay was used to detect Trypanosoma cruzi IgG antibodies in capillary blood samples from patients 72 months after treatment. Fisher's exact test was used to establish association between characteristics, such as sex, age, and origin of patients, and fi nal seroconversion. Kappa index determined concordance between laboratory tests. The level of signifi cance was set to 5%. Results: Ninety-eight patients, aged 6 months to 16 years, were available for follow-up. Sex and origin were not associated with seroconversion. Individuals older than 13 were more prone to maintain a positive result 72 months after treatment, although results were not highly signifi cant. Laboratory tests presented elevated Kappa concordance (95% CI) = 0.8290 (0.4955-1), as well as high (97%) seroconversion rates. Conclusions: The high seroconversion rate found in this study emphasizes the importance of access to diagnosis, treatment, and follow-up of individuals affected by Chagas disease. Moreover, it contradicts the idea that it is not possible to achieve a cure with the currently available drugs. This study strongly supports expanding programs for patients infected with T. cruzi in endemic and non-endemic countries.

A novel antibody surrogate biomarker to monitor parasite persistence in Trypanosoma cruzi-infected patients

“…Nonetheless, it is generally agreed that BZN-treatment contributes to decreasing the parasitic load resulting in a decline in antibody titers, and consequently is likely to improve clinical outcomes if applied early in the chronic phase of the infection [ 14 ] [ 16 ] [ 17 ]. Several other factors also affect the drug success rate such as the genotype of the parasite, the age of the patients, the interval between infection and start of treatment, and the clinical stage of the disease when therapy is given [ 11 ] [ 18 ].…”

Animal models of Chagas disease and their translational value to drug development

“…These drugs have been shown to be effective in the acute phase of the disease and evidence is mounting for their efficacy in the chronic phase, especially in children. Their use is limited by poor access and substantial side-effects, not to mention the lack for a test of cure in chronically infected adults [22,23,24,25,26,27]. This highlights a clear priority for better and safer antiparasitic drugs for CD and, importantly, the search for adequate markers or surrogates of parasitological cure.…”

Chagas Disease Treatment Efficacy Biomarkers: Myths and Realities

“…There are two treatments currently available, benznidazole (Abarax/ELEA and Rochagan/LAFEPE) and nifurtimox (Lampit/Bayer), which are old nitroheterocyclic trypanocidal drugs. Although these drugs have been shown to be efficacious in both phases of the disease, particularly in children, their use is limited due to side effects occurring during treatment and impeded access to medication [14,15]. There is an urgent need for new and safer drugs for CD.…”