Usefulness of PCR Strategies For Early Diagnosis of Chagas' Disease Reactivation and Treatment Follow-Up in Heart Transplantation

Díez, Mirta; Favaloro, Liliana; Bertolotti, Alejandro; Burgos, Juan Miguel; Vigliano, Carlos; Lastra, M. Peradejordi; Levìn, Mariano J.; Arnedo, Alberto; Nagel, Claudia; Schijman, Alejandro G.; Favaloro, Roberto

doi:10.1111/j.1600-6143.2007.01820.x

Cited by 172 publications

(158 citation statements)

References 24 publications

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…Currently available high-sensitivity methodologies, such as serial RT-PCR, allow for the early detection of rising circulating T. cruzi levels before the appearance of clinical symptoms of reactivation, which can lead to precocious specific treatment to avoid possible subsequent complications. [30][31][32] New drugs approved for use in humans for other indications, such as new antifungal triazole derivatives that are selective inhibitors of T. cruzi ergosterol synthesis (acting at the level of C14α sterol demethylase, CYP51), are promising alternatives for specific chronic CD treatment; these compounds have high anti-T. cruzi efficacy in vitro and in experimental animal models of both acute and chronic CD, and they are active against nifurtimox-and benznidazole-resistant strains of T. cruzi , even in immunosuppressed hosts. 33 The remarkable in vivo anti-T. cruzi activities of these compounds are thought to result from their potent intrinsic activity against the parasite (minimal inhibitory concentrations against intracellular amastigotes in vitro in the low nanomolar to subnanomolar range) and special pharmacokinetic properties, such as long terminal half-life and large volumes of distribution.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment with Posaconazole of a Patient with Chronic Chagas Disease and Systemic Lupus Erythematosus

Pinazo¹,

Espinosa²,

Gállego³

et al. 2010

The American Journal of Tropical Medicine and Hygiene

125

View full text Add to dashboard Cite

Abstract. American Trypanosomiasis or Chagas disease (CD) is a neglected disease that affects Latin American people worldwide. Two old antiparasitic drugs, benznidazole and nifurtimox, are currently used for specific CD treatment with limited efficacy in chronic infections and frequent side effects. New drugs are needed for patients with chronic CD as well as for immunosuppressed patients, for whom the risk of reactivation is life-threatening. We describe a case of chronic CD and systemic lupus erythematosus (SLE) that required immunosuppression to control the autoimmune process. It was found that benznidazole induced a reduction, but not an elimination, of circulating Trypanosoma cruzi levels, whereas subsequent treatment with posaconazole led to a successful resolution of the infection, despite the maintenance of immunosuppressive therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Successful Treatment with Posaconazole of a Patient with Chronic Chagas Disease and Systemic Lupus Erythematosus

Pinazo¹,

Espinosa²,

Gállego³

et al. 2010

The American Journal of Tropical Medicine and Hygiene

125

View full text Add to dashboard Cite

show abstract

“…Quantitative PCR assays (e.g., real-time PCR) are useful to monitor for reactivation in the immunosuppressed T. cruzi-infected host. In these patients, a positive result on conventional PCR does not prove reactivation, but quantitative PCR assays that indicate rising parasite numbers over time provide the earliest and most sensitive indicator of reactivation (89,92).…”

Section: Utility Of Pcr For Diagnosis or Monitoringmentioning

confidence: 99%

Trypanosoma cruzi and Chagas' Disease in the United States

et al. 2011

View full text Add to dashboard Cite

SUMMARY Chagas' disease is caused by the protozoan parasite Trypanosoma cruzi and causes potentially life-threatening disease of the heart and gastrointestinal tract. The southern half of the United States contains enzootic cycles of T. cruzi , involving 11 recognized triatomine vector species. The greatest vector diversity and density occur in the western United States, where woodrats are the most common reservoir; other rodents, raccoons, skunks, and coyotes are also infected with T. cruzi. In the eastern United States, the prevalence of T. cruzi is highest in raccoons, opossums, armadillos, and skunks. A total of 7 autochthonous vector-borne human infections have been reported in Texas, California, Tennessee, and Louisiana; many others are thought to go unrecognized. Nevertheless, most T. cruzi -infected individuals in the United States are immigrants from areas of endemicity in Latin America. Seven transfusion-associated and 6 organ donor-derived T. cruzi infections have been documented in the United States and Canada. As improved control of vector- and blood-borne T. cruzi transmission decreases the burden in countries where the disease is historically endemic and imported Chagas' disease is increasingly recognized outside Latin America, the United States can play an important role in addressing the altered epidemiology of Chagas' disease in the 21st century.

show abstract

“…PCR performed on DNA extracted from peripheral blood is useful for the early diagnosis of reactivated Chagas' disease (373) and for monitoring treatment efficacy (74,171). PCR may also be performed on tissue biopsy specimens for the molecular characterization of strains/isolates (74) or to demonstrate the chronic persistence of trypanosomes in tissues (40).…”

Section: Trypanosomamentioning

confidence: 99%

Importance of Nonenteric Protozoan Infections in Immunocompromised People

et al. 2010

View full text Add to dashboard Cite

SUMMARY There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed.

show abstract

Usefulness of PCR Strategies For Early Diagnosis of Chagas' Disease Reactivation and Treatment Follow-Up in Heart Transplantation

Cited by 172 publications

References 24 publications

Successful Treatment with Posaconazole of a Patient with Chronic Chagas Disease and Systemic Lupus Erythematosus

Successful Treatment with Posaconazole of a Patient with Chronic Chagas Disease and Systemic Lupus Erythematosus

Trypanosoma cruzi and Chagas' Disease in the United States

Importance of Nonenteric Protozoan Infections in Immunocompromised People

Contact Info

Product

Resources

About