Parasite persistence in treated chagasic patients revealed by xenodiagnosis and polymerase chain reaction

Mem Inst Oswaldo Cruz. 2001 Aug;96(6):823-6. doi: 10.1590/s0074-02762001000600014.

Abstract

Polymerase chain reaction (PCR) was compared with xenodiagnosis performed 20 years after trypanocidal chemotherapy to investigate parasite clearance. Eighty-five seropositive individuals for Chagas disease presenting a positive xenodiagnosis were treated with specific drugs; 37 in the acute phase and 48 in the chronic phase. Fifteen chronic asymptomatic patients received a placebo. Treatment in the acute phase led to PCR negative results in 73% of the cases, while xenodiagnosis was negative in 86%. In the chronic phase, PCR was negative in 65% of the patients and 83% led to xenodiagnosis negative results. Regarding the untreated group (placebo), 73% gave negative results by xenodiagnosis, of which 36% were positive by PCR. Individuals that were considered seronegative (n=10), presented unequivocally negative results in the PCR demonstrating the elimination of parasite DNA. Seventeen individuals had their antibodies titers decreased to such a level that the final results were considered as doubtful and 16 of them presented negative PCR. The molecular method represents a clear advantage over conventional techniques to demonstrate persistent infections in Chagas disease patients that underwent chemotherapy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Animals
  • Chagas Disease / drug therapy
  • Chagas Disease / parasitology*
  • Chi-Square Distribution
  • Chronic Disease
  • DNA, Kinetoplast / analysis
  • Follow-Up Studies
  • Humans
  • Polymerase Chain Reaction*
  • Sensitivity and Specificity
  • Trypanocidal Agents / therapeutic use
  • Xenodiagnosis*

Substances

  • DNA, Kinetoplast
  • Trypanocidal Agents