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Success of benznidazole chemotherapy in chronic Trypanosoma cruzi-infected patients with a sustained negative PCR result

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Abstract

Cure assessment in chronic Trypanosoma cruzi infection is controversial, mainly because of the lack of reliable tests to ensure parasite elimination. Here, we assess the impact of benznidazole therapy on the conventional serology and parasitaemia in chronic Chagas disease. A total of 455 patients with long-term Trypanosoma cruzi infection underwent specific chemotherapy with benznidazole. Their parasitological status was assessed by polymerase chain reaction (PCR) detection of T. cruzi DNA. Drops in the titres of antibody levels were serially measured by indirect immunofluorescence assay (IFI) and chemiluminescent microparticle immunoassay (CMIA). Patients were monitored during the treatment period and for a further 90, 150 and 240 days. Controls were repeated yearly during the 7-year follow-up. The PCR result was negative in all patients between 60-day (n = 22) and 90-day (n = 294) controls. Treatment failure was detected in 45 patients and was significantly more frequent in those who did not complete the therapy [12 out of 13 (92 %) vs. 33 out of 442 (7 %)] (p = 0.0001). A significant drop in serum titres was detected after the first follow-up year in patients with sustained negative PCR results: 2nd year (p = 0.029 by IFI; p = 0.002 by CMIA), 5th year (p = 0.036 by IFI; p = 0.039 by CMIA) and 6th year (p = 0.028 by IFI; p = 0.019 by CMIA). The results point to a beneficial effect of benznidazole and may be the cure of chronic patients who had a consistently negative PCR result throughout the follow-up period.

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Authors and Affiliations

  1. Unidad Regional de Medicina Tropical, Servicio de Microbiología, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Carretera Madrid-Cartagena sn,30120- El Palmar, Murcia, Spain

    L. Murcia, B. Carrilero, F. Ferrer, M. Roig, F. Franco & M. Segovia

  2. Departamento de Genética y Microbiología, Universidad de Murcia, Murcia, Spain

    L. Murcia & M. Segovia

Authors
  1. L. Murcia
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  2. B. Carrilero
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  3. F. Ferrer
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  4. M. Roig
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  5. F. Franco
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  6. M. Segovia
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Correspondence to L. Murcia.

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Funding source

This study was supported by the Instituto de Salud Carlos III within the Network of Tropical Diseases Research (grant RICET RD12/0018/0018).

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The authors declare that they have no conflict of interest.

Ethical approval

The study was reviewed and approved by the Ethical Committee of the Hospital Virgen de la Arrixaca.

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Written informed consent was obtained from all patients enrolled in the study.

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Murcia, L., Carrilero, B., Ferrer, F. et al. Success of benznidazole chemotherapy in chronic Trypanosoma cruzi-infected patients with a sustained negative PCR result. Eur J Clin Microbiol Infect Dis 35, 1819–1827 (2016). https://doi.org/10.1007/s10096-016-2733-6

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  • DOI: https://doi.org/10.1007/s10096-016-2733-6

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