Benznidazole as Prophylaxis for Chagas Disease Infection Reactivation in Heart Transplant Patients: A Case Series in Brazil
| Autor: | Marco Aurélio Finger, Carolina Casadei Dos Santos, João Manoel Rossi Neto |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Chagas disease
medicine.medical_specialty medicine.medical_treatment 030231 tropical medicine lcsh:Medicine chagas disease reactivation 030230 surgery Logistic regression Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine heart transplant Heart transplantation General Immunology and Microbiology business.industry Incidence (epidemiology) lcsh:R Public Health Environmental and Occupational Health chagasic cardiomyopathy medicine.disease Transplantation Infectious Diseases Benznidazole Transplant patient business medicine.drug |
| Zdroj: | Tropical Medicine and Infectious Disease; Volume 5; Issue 3; Pages: 132 Tropical Medicine and Infectious Disease, Vol 5, Iss 132, p 132 (2020) Tropical Medicine and Infectious Disease |
| ISSN: | 2414-6366 |
| DOI: | 10.3390/tropicalmed5030132 |
| Popis: | Background—Patients with Chagas cardiomyopathy (CC) have high mortality, and CC is a common indication for heart transplantation (HTx) in endemic countries. Chagas disease reactivation (CDR) is common after transplantation and is likely to cause adverse outcomes unless detected and treated appropriately. This study reviews our experiences with HTx among patients with CC, and the use of benznidazole (BZ) before transplantation. Methods—During the 18-year period from 1996 through 2014, 70 of 353 patients who underwent HTx (19.8%) had CC, and 53 patients met the inclusion criteria. The effectiveness of prophylactic treatment with BZ (dose of 5 mg/kg/day, two times per day, for at least four weeks and for a maximum of eight weeks) was determined based on the observed reduction in the incidence of CDR during the post-HTx period. Results—Prophylactic therapy was administered to 18/53 patients (34.0%). During the follow-up period, the incidence rate of CDR in our study was 34.0% (18/53). Based on logistic regression analysis, only prophylaxis (OR = 0.12; CI 0.02–0.76; p = 0.025) was considered to protect against CDR. Conclusion—Our study suggests that the use of BZ may reduce the incidence of CDR in patients undergoing HTx and warrants further investigation in a prospective, randomized trial. |
| Databáze: | OpenAIRE |
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