Quantitative PCR as a marker for preemptive therapy and its role in therapeutic control in <i>Trypanosoma cruzi</i>/HIV coinfection

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article
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2024
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Scopus
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PubMed
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PUBLIC LIBRARY SCIENCE
Autores
SILVA, Sheila Cristina Vicente da
NAKANISHI, erika Shimoda
SALVADOR, Fernando
CASTRO, Cleudson Nery de
BEZERRA, Rita Cristina
WESTPHALEN, Elizabeth Visone Nunes
Citação
PLOS NEGLECTED TROPICAL DISEASES, v.18, n.2, article ID e0011961, 24p, 2024
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Background Trypanosoma cruzi and HIV coinfection can evolve with depression of cellular immunity and increased parasitemia. We applied quantitative PCR (qPCR) as a marker for preemptive antiparasitic treatment to avoid fatal Chagas disease reactivation and analyzed the outcome of treated cases. Methodology This mixed cross-sectional and longitudinal study included 171 Chagas disease patients, 60 coinfected with HIV. Of these 60 patients, ten showed Chagas disease reactivation, confirmed by parasites identified in the blood, cerebrospinal fluid, or tissues, 12 exhibited high parasitemia without reactivation, and 38 had low parasitemia and no reactivation. Results We showed, for the first time, the success of the timely introduction of benznidazole in the non-reactivated group with high levels of parasitemia detected by qPCR and the absence of parasites in reactivated cases with at least 58 days of benznidazole. All HIV+ patients with or without reactivation had a 4.0-5.1 higher chance of having parasitemia than HIV seronegative cases. A positive correlation was found between parasites and viral loads. Remarkably, treated T. cruzi/HIV-coinfected patients had 77.3% conversion from positive to negative parasitemia compared to 19.1% of untreated patients. Additionally, untreated patients showed similar to 13.6 times higher Odds Ratio of having positive parasitemia in the follow-up period compared with treated patients. Treated and untreated patients showed no differences regarding the evolution of Chagas disease. The main factors associated with all-cause mortality were higher parasitemia, lower CD4 counts/mu L, higher viral load, and absence of antiretroviral therapy. Conclusion We recommend qPCR prospective monitoring of T. cruzi parasitemia in HIV+ coinfected patients and point out the value of pre-emptive therapy for those with high parasitemia. In parallel, early antiretroviral therapy introduction is advisable, aiming at viral load control, immune response restoration, and increasing survival. We also suggest an early antiparasitic treatment for all coinfected patients, followed by effectiveness analysis alongside antiretroviral therapy.
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https://observatorio.fm.usp.br/handle/OPI/58892
Referências
  1. Almeida EA, 2010, T ROY SOC TROP MED H, V104, P447, DOI 10.1016/j.trstmh.2010.02.004
  2. Angheben A, 2011, EUROSURVEILLANCE, V16, P2
  3. Angheben A, 2015, BLOOD TRANSFUS-ITALY, V13, P540, DOI 10.2450/2015.0040-15
  4. AVILA HA, 1991, MOL BIOCHEM PARASIT, V48, P211, DOI 10.1016/0166-6851(91)90116-N
  5. Marcon GEB, 2022, PLOS NEGLECT TROP D, V16, DOI 10.1371/journal.pntd.0010317
  6. Basquiera AL, 2003, HEART, V89, P1186, DOI 10.1136/heart.89.10.1186
  7. Benchetrit A, 2017, AIDS RES HUM RETROV, V33, P330, DOI [10.1089/AID.2016.0068, 10.1089/aid.2016.0068]
  8. Besuschio SA, 2020, PLOS NEGLECT TROP D, V14, DOI 10.1371/journal.pntd.0008402
  9. Brasil. Ministerio da Saude. Secretaria de Vigilancia em Saude, 2003, Criterios de definicao de casos de aids em adultos e criancas/ Ministerio da Saude, Secretaria de Vigilancia em Saude, p56p
  10. Callegari-Jacques SM., 2003, Principios e Aplicacoes, V20, P166
  11. Centers for Disease Control and Prevention (CDC), 2002, MMWR Morb Mortal Wkly Rep, V15;51, P210
  12. Cura CI, 2013, AM J TRANSPLANT, V13, P3253, DOI 10.1111/ajt.12487
  13. de Almeida EA, 2011, REV SOC BRAS MED TRO, V44, P762, DOI 10.1590/S0037-86822011000600021
  14. DELCASTILLO M, 1990, AM J MED, V88, P693, DOI 10.1016/0002-9343(90)90544-N
  15. Dolcini G, 2008, REV ARGENT MICROBIOL, V40, P164
  16. Duffy T, 2009, PLOS NEGLECT TROP D, V3, DOI 10.1371/journal.pntd.0000419
  17. Farani PSG, 2023, PLOS NEGLECT TROP D, V17, DOI 10.1371/journal.pntd.0011223
  18. Fragata AA, 2016, PLOS NEGLECT TROP D, V10, DOI 10.1371/journal.pntd.0004508
  19. Freitas VLT., 2024, Dryad, DOI [10.5061/dryad.05qfttf8f, DOI 10.5061/DRYAD.05QFTTF8F]
  20. Gallerano R R, 2000, Rev Fac Cien Med Univ Nac Cordoba, V57, P135
  21. Hasslocher-Moreno AM, 2022, REV SOC BRAS MED TRO, V55, DOI 10.1590/0037-8682-0240-2022
  22. Imai K, 2015, PARASITOL INT, V64, P240, DOI 10.1016/j.parint.2015.02.005
  23. Jackson Y, 2010, PLOS NEGLECT TROP D, V4, DOI 10.1371/journal.pntd.0000592
  24. Lazarte Raul A., 2012, Morbidity and Mortality Weekly Report, V61, P477
  25. Lescure F-X, 2009, Bull Soc Pathol Exot, V102, P295
  26. Neto JAM, 2023, ARQ BRAS CARDIOL, V120, DOI 10.36660/abc.20230269
  27. Mascola L., 2006, Morbidity and Mortality Weekly Report, V55, P798
  28. Molina I, 2014, NEW ENGL J MED, V370, P1899, DOI 10.1056/NEJMoa1313122
  29. Morillo CA, 2015, NEW ENGL J MED, V373, P1295, DOI 10.1056/NEJMoa1507574
  30. Navarro IC, 2015, PLOS NEGLECT TROP D, V9, DOI 10.1371/journal.pntd.0003828
  31. Pinazo MJ, 2013, PLOS NEGLECT TROP D, V7, DOI 10.1371/journal.pntd.0001965
  32. Dias JCP, 2016, REV SOC BRAS MED TRO, V49, P3, DOI 10.1590/0037-8682-0505-2016
  33. Ferreira LRP, 2017, SCI REP-UK, V7, DOI 10.1038/s41598-017-18080-9
  34. Piron M, 2007, ACTA TROP, V103, P195, DOI 10.1016/j.actatropica.2007.05.019
  35. Portela-Lindoso AAB, 2003, REV SAUDE PUBL, V37, P107, DOI 10.1590/S0034-89102003000100016
  36. Reimer-McAtee MJ, 2021, AM J TROP MED HYG, V105, P643, DOI 10.4269/ajtmh.20-1141
  37. Sabino EC, 2015, EUR J HEART FAIL, V17, P416, DOI 10.1002/ejhf.220
  38. Salvador F, 2015, CLIN MICROBIOL INFEC, V21, P854, DOI 10.1016/j.cmi.2015.05.033
  39. Sartori AMC, 2007, ANN TROP MED PARASIT, V101, P31, DOI 10.1179/136485907X154629
  40. Schmunis GA, 2010, ACTA TROP, V115, P14, DOI 10.1016/j.actatropica.2009.11.003
  41. Sguassero Y, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0139363
  42. Shikanai-Yasuda MA., 2020, Chagas Disease. Chap, V13, P213, DOI [10.1007/978-3-030-44054-1, DOI 10.1007/978-3-030-44054-1]
  43. Shikanai-Yasuda MA, 2021, PLOS NEGLECT TROP D, V15, DOI 10.1371/journal.pntd.0009809
  44. SILVA JS, 1993, AM J TROP MED HYG, V49, P589, DOI 10.4269/ajtmh.1993.49.589
  45. Sosa-Estani S, 2009, MEM I OSWALDO CRUZ, V104, P167, DOI 10.1590/S0074-02762009000900023
  46. Stauffert D, 2017, BRAZ J INFECT DIS, V21, P180
  47. de Freitas VLT, 2011, PLOS NEGLECT TROP D, V5, DOI 10.1371/journal.pntd.0001277
  48. VIOTTI R, 1994, AM HEART J, V127, P151, DOI 10.1016/0002-8703(94)90521-5
  49. Viotti R, 2006, ANN INTERN MED, V144, P724, DOI 10.7326/0003-4819-144-10-200605160-00006
  50. Virreira M, 2007, AM J TROP MED HYG, V77, P102, DOI 10.4269/ajtmh.2007.77.102
  51. World Health Organization, 2007, WHO Region of the Americas
  52. World Health Organization, Chagas disease (also known as American trypanosomiasis) 01/04/2021
  53. Yun O, 2009, PLOS NEGLECT TROP D, V3, DOI 10.1371/journal.pntd.0000488

Coleções
Artigos e Materiais de Revistas Científicas - FM/MIP