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Current Treatment of Chagas Disease

  • Neglected Tropical Diseases (A Sanchez, Section Editor)
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Abstract

Purpose of review

Chagas disease (CD) is recognized as a neglected tropical disease. It is endemic of Latin America, but globalization has led to its spread worldwide. Even though its presence has been tracked at least 9000 years ago, treatment options remain scarce. The purpose of this review is to analyze the evidence for current and future options to combat the disease.

Recent findings

CD patients benefit from dietary and exercise recommendations. Benznidazole and nifurtimox continue to be the available treatment options. Besides them, several drugs have been developed, repurposed, and tested in clinical trials, mostly inhibitors of the ergosterol synthesis like albaconazole, itraconazole, posaconazole, ravuconazole/fosravuconazole, voriconazole, and TAK-187; antiarrhythmics like amiodarone/dronedarone; inhibitors of the purine synthesis like allopurinol; nitroimidazoles like fexinidazole; and minerals like selenium. Even though they have shown in vitro and in vivo activity against Trypanosoma cruzi, their effectiveness is inferior to the one from benznidazole. Chronic CD patients who develop the cardio-digestive forms of the disease may eventually need assistive devices and/or surgical procedures to improve their outcome.

Summary

Benznidazole and nifurtimox are the only trypanosomal drugs available to combat T. cruzi infection, and their effectiveness relies upon the stage of the disease at where the patients are. Their side effects frequently lead to patient’s non-compliance to treatment. Therefore, more effective drugs with a better safety profile are required. Up to date, controversial and promising results have been observed. Further compromise and research must be encouraged to tackle the challenges of developing new effective and safer drugs for CD patients.

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Authors and Affiliations

  1. Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, WC1E 7HT, Bloomsbury, London, UK

    Diego-Abelardo Álvarez-Hernández MBBS, MSHc & Luis-Alberto Martínez-Juárez MBBS, MPH, DrPHc

  2. Faculty of Health Sciences, Anahuac University Mexico-North Campus, 52786, Huixquilucan, Mexico State, Mexico

    Diego-Abelardo Álvarez-Hernández MBBS, MSHc, Zaira-Leticia Castro-Rico MBBS, MHA, Rodolfo García-Rodríguez-Arana MBBS, MHA & Rosalino Vázquez-López BVMS, MMMI, PhD

  3. Faculty of Health Sciences, Panamerican University, Insurgentes Mixcoac, 03920, Mexico City, Mexico

    Alberto-Manuel González-Chávez MBBS, SGS & Mario-Andrés González-Chávez MBBS, SGS

  4. Department of General Surgery, Spanish Hospital of Mexico, Granada, 11520, Mexico City, Mexico

    Alberto-Manuel González-Chávez MBBS, SGS & Mario-Andrés González-Chávez MBBS, SGS

  5. Department of Medical Affairs, CF Medical Solutions, 92430, Marnes la Coquette, France

    Claudia Ferreira MD, PhD

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Correspondence to Diego-Abelardo Álvarez-Hernández MBBS, MSHc.

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Diego-Abelardo Álvarez-Hernández declares that he has no conflict of interest. Zaira-Leticia Castro-Rico declares that she has no conflict of interest. Rodolfo García-Rodríguez-Arana declares that he has no conflict of interest. Alberto-Manuel González-Chávez declares that he has no conflict of interest. Mario-Andrés González-Chávez declares that he has no conflict of interest. Luis-Alberto Martínez-Juárez declares that he has no conflict of interest. Claudia Ferreira declares that she has no conflict of interest. Rosalino Vázquez-López declares that he has no conflict of interest.

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Álvarez-Hernández, DA., Castro-Rico, ZL., García-Rodríguez-Arana, R. et al. Current Treatment of Chagas Disease. Curr Treat Options Infect Dis 12, 438–457 (2020). https://doi.org/10.1007/s40506-020-00238-1

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