Chronic Chagas cardiopathy in Chile. Importance of Trypanosoma cruzi burden and clinical evaluation

Apt, Werner; Arribada, A; Zulantay, Inés; Saavedra, Miguel; Muñoz, Catalina; Toro, Bruno; Vega, Bastián; Rodríguez, Jorge

doi:10.1016/j.actatropica.2016.06.025

Cited by 11 publications

(19 citation statements)

References 38 publications

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“…eq.⁄mL [33], higher than previously described for the same group of patients, fluctuating between <0.1 and 7.9 par. eq.⁄mL [30]. Studies have shown that qPCR has been used for the detection and quantification of T .…”

Section: Discussionmentioning

confidence: 99%

Monitoring the parasite load in chronic Chagas disease patients: comparison between blood culture and quantitative real time PCR

et al. 2018

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BackgroundDespite the improvements in diagnostic tools for detection of Trypanosoma cruzi in human blood samples, the isolation of parasite from bloodstream in the chronic phase of Chagas disease is challenging. Thus, there is an increasing interest in the development of strategies that allow an accurate monitoring of the parasite load in bloodstream of Chagas disease patients. Given that, the comparison of a classical diagnostic method such as blood culture and multiplex quantitative real-time PCR (qPCR) was few explored so far. Therefore, this study aimed to compare the detection and quantification of T. cruzi load in the circulating blood of patients with chronic Chagas disease, using blood culture and qPCR techniques.Methods⁄Principal findingsThe multiplex real-time quantitative PCR assay (qPCR) based on TaqMan technology was evaluated in 135 blood samples from 91 patients with chronic Chagas disease presenting indeterminate (asymptomatic, n = 23) and cardiac (chronic cardiomyopathy, n = 68) forms, in comparison with the classical blood culture (BC) technique. The total positivity of qPCR and BC was 58.5% and 49.6%, respectively. The median parasite load of all positive patients was 1.18 [0.39–4.23] par. eq.⁄mL, ranging from 0.01 to 116.10 par. eq.⁄mL. We did not find significant differences between T. cruzi load with age and distinct clinical manifestations of patients.Conclusions/SignificanceOur data suggest that qPCR can be an auxiliary tool for studies that require T. cruzi isolation from the bloodstream of patients with chronic Chagas disease, after the establishment of a parasite load cut-off that guarantees a relative success rate of parasite isolation using BC technique.

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Section: Discussionmentioning

confidence: 99%

Monitoring the parasite load in chronic Chagas disease patients: comparison between blood culture and quantitative real time PCR

et al. 2018

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“…In a still largely unclear scenario relating cytokines and pathogenesis of Chagas disease, our study seeked for potential associations between strategic cytokine-related SNVs and key Chagas phenotypes restricted to the disease or combined with immune dysregulation. T. cruzi parasitemia has been recognized as an element that accelerates chronic Chagas cardiopathy (19,20,22), although some reports question this effect (23)(24)(25). PCR-based T. cruzi detection in human biopsies supports that parasite persistence in the heart favors the progression of cardiomyopathy (19,21).…”

Section: Hiv Infection Is Protective Against Development and Progressmentioning

confidence: 99%

“…cruzi parasitemia is another major factor implicated in the progression of chronic Chagas cardiopathy, even if intermittent and low at this disease stage (19)(20)(21)(22). Available reports, however, are controversial on this point (23)(24)(25). Cytokines have also been shown to control T. cruzi parasitic burden and myocardial inflammatory lesions in both chronic and acute phases of murine infection.…”

Section: Introductionmentioning

confidence: 99%

A Specific IL6 Polymorphic Genotype Modulates the Risk of Trypanosoma cruzi Parasitemia While IL18, IL17A, and IL1B Variant Profiles and HIV Infection Protect Against Cardiomyopathy in Chagas Disease

et al. 2020

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Background: Chagas disease caused by Trypanosoma cruzi (T. cruzi) affects approximately six million individuals worldwide. Clinical manifestations are expected to occur due to the parasite persistence and host immune response. Herein we investigated potential associations between IL1B, IL6, IL17A, or IL18 polymorphism profiles and cardiomyopathy or T. cruzi parasitemia, as well as the impact of HIV infection on cardiopathy. Methods: Two hundred twenty-six patients and 90 control individuals were analyzed. IL1B rs1143627 T>C, IL6 rs1800795 C>G, IL17A rs2275913 G>A, IL18 rs187238 C>G, and IL18 rs1946518 C>A SNVs were analyzed by real-time PCR and T. cruzi parasitemia by PCR. Results: Our data revealed association between a cytokine gene polymorphism and parasitemia never previously reported. The IL6 rs1800795 CG genotype lowered the risk of positive parasitemia (OR = 0.45, 95% CI 0.24-0.86, P = 0.015). Original findings included associations between IL17A rs2275913 AA and IL18 s1946518 AA genotypes with decreased risk of developing cardiomyopathy (OR = 0.27, 95% CI 0.07-0.97, P = 0.044; and OR = 0.35, 95% CI 0.14-0.87, P = 0.023, respectively). IL18 rs1946518 AA and IL1B rs1143627 TC were associated with reduced risk for

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“…Finally, we included 12 studies comprising 1,686 patients (12,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45), which are described in Table 1. Eight studies were cross-sectional studies, 3 were designed as prospective cohorts, and 1 was a case-control study.…”

Section: Resultsmentioning

confidence: 99%

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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Chronic Chagas cardiopathy in Chile. Importance of Trypanosoma cruzi burden and clinical evaluation

Cited by 11 publications

References 38 publications

Monitoring the parasite load in chronic Chagas disease patients: comparison between blood culture and quantitative real time PCR

Monitoring the parasite load in chronic Chagas disease patients: comparison between blood culture and quantitative real time PCR

A Specific IL6 Polymorphic Genotype Modulates the Risk of Trypanosoma cruzi Parasitemia While IL18, IL17A, and IL1B Variant Profiles and HIV Infection Protect Against Cardiomyopathy in Chagas Disease

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

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