Clinical Follow-Up of Responses to Treatment with Benznidazol in Amazon: A Cohort Study of Acute Chagas Disease

Autor: Angela Cristina Verissimo Junqueira, Sebastião Aldo da Silva Valente, Alberto Ferreira, Vera da Costa Valente, Laura Cristina Santos, Ana Yecê das Neves Pinto, José Rodrigues Coura, Roberto Cavalleiro de Macedo
Rok vydání: 2013
Předmět:
Chagas Cardiomyopathy
Non-Clinical Medicine
Hemagglutination
Epidemiology
Antibodies
Protozoan
lcsh:Medicine
Buffy coat
Serology
Cohort Studies
Blood culture
Child
lcsh:Science
Multidisciplinary
medicine.diagnostic_test
Antibody titer
Middle Aged
Trypanocidal Agents
Treatment Outcome
Infectious Diseases
Nitroimidazoles
Benznidazole
Child
Preschool
Acute Disease
Disease Progression
Medicine
Topography
Medical
Public Health
Brazil
Research Article
medicine.drug
Adult
Chagas disease
Drugs and Devices
medicine.medical_specialty
Adolescent
Clinical Research Design
Trypanosoma cruzi
Infectious Disease Epidemiology
Young Adult
Internal medicine
Parasitic Diseases
medicine
Humans
Chagas Disease
Biology
Aged
Treatment Guidelines
Health Care Policy
Population Biology
business.industry
lcsh:R
medicine.disease
Immunoglobulin G
Immunology
lcsh:Q
business
Xenodiagnosis
Follow-Up Studies
Zdroj: PLoS ONE, Vol 8, Iss 5, p e64450 (2013)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0064450
Popis: A total of 179 individuals with acute Chagas disease mainly transmitted by oral source, from Pará and Amapá State, Amazonian, Brazil were included during the period from 1988 to 2005. Blood samples were used to survey peripheral blood for T. cruzi hemoparasites by quantitative buffy coat (QBC), indirect xenodiagnosis, blood culture and serology to detection of total IgM and anti-T. cruzi IgG antibodies by indirect immunofluorescence assay (IFA) and indirect hemagglutination assay (HA). All assays were performed pre-treatment (0 days) and repeated 35 (±7) and 68 (±6) days after the initiation of treatment with benznidazol and every 6 months while remained seropositive. The endpoint of collection was performed in 2005. Total medium period of follow-up per person was 5.6 years. Also, a blood sample was collected from 72 randomly chosen treated patients to perform polimerase chain reaction (PCR) method. Proportions of subjects with negative or positive serology according to the number of years after treatment were compared. In the endpoint of follow-up we found 47 patients (26.7%) serologically negative, therefore considered cured and 5 (2.7%) exhibited mild cardiac Chagas disease. Other 132 patients had persistent positive serologic tests. The PCR carried out in 72 individuals was positive in 9.8%. Added, there was evidence of therapeutic failure immediately following treatment, as demonstrated by xenodiagnosis and blood culture methods in 2.3% and 3.5% of cases, respectively. There was a strong evidence of antibody clearing in the fourth year after treatment and continuous decrease of antibody titers. Authors suggest that control programs should apply operational researches with new drug interventions four years after the acute phase for those treated patients with persistently positive serology.
Databáze: OpenAIRE
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