Monitoring the efficacy of specific treatment in chronic Chagas disease by polymerase chain reaction and flow cytometry analysis

Abstract

Summary :PCR and FC-ALTA were used to monitor parasite clearance in 54 chronic chagasic patients who had completed therapy with allopurinol (ALLO, n = 31) or itraconazole (ITRA, n = 23) ten years earlier. All patients maintained positive conventional serology. 25 of them showed positive XD (ALLO, n = 11 and ITRA, n = 14) and 29 negative XD (ALLO, n = 20 and ITRA, n = 9). 43 patients were positive by both techniques (ALLO, n = 23 and ITRA, n = 20). Seven of 54 patients were negative by PCR and positive by FC-ALTA and three of 54 were positive by PCR and negative by FC-ALTA. Only one case with both tests negative should be considered cured. Of 29 patients with negative XD, 14 treated ALLO (70 %) and nine with ITRA (77.8 %) showed positive PCR and FC-ALTA. These results do not show differences of efficacy among the drugs, and reinforce the relevance of using sensitive tools such as PCR and FC-ALTA for the follow-up of patients with chronic Chagas disease. Résumé : ÉVALUATION DE L'EFFICACITÉ DE TRAITEMENTS SPÉCIFIQUES DE LA MALADIE DE CHAGAS PAR PCR ET CYTOMÉTRIE DE FLUX La PCR et la cytométrie de flux (FC-ALTA) ont été employées pour vérifier la guérison de 54 patients infectés par

Diagnosis of Chagas disease: what has been achieved? What remains to be done with regard to diagnosis and follow up studies?

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Follow-up of an Asymptomatic Chagas Disease Population of Children after Treatment with Nifurtimox (Lampit) in a Sylvatic Endemic Transmission Area of Colombia

“…Several studies have demonstrated the usefulness of this test to assess the therapeutic response and the treatment efficacy because it exhibits greater sensitivity than other parasitological tests, especially during acute cases and congenital infection or reactivation. Molecular tests, unlike serological tests, allow the short-term detection of treatment failure [26,34–36]. Real-time PCR (qPCR) allows for the quantification of the parasite load in samples from patients with T. cruzi infection, and this test has been proposed as a marker of therapeutic response.…”

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