Clinical follow-up of responses to treatment with benznidazol in Amazon: a cohort study of acute Chagas disease.

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), indi...

Full description

Bibliographic Details
Main Authors: Ana Yecê das Neves Pinto, Vera da Costa Valente, José Rodrigues Coura, Sebastião Aldo da Silva Valente, Angela Cristina Veríssimo Junqueira, Laura Cristina Santos, Alberto Gomes Ferreira, Roberto Cavalleiro de Macedo
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3664625?pdf=render
_version_ 1818042051318513664
author Ana Yecê das Neves Pinto
Vera da Costa Valente
José Rodrigues Coura
Sebastião Aldo da Silva Valente
Angela Cristina Veríssimo Junqueira
Laura Cristina Santos
Alberto Gomes Ferreira
Roberto Cavalleiro de Macedo
author_facet Ana Yecê das Neves Pinto
Vera da Costa Valente
José Rodrigues Coura
Sebastião Aldo da Silva Valente
Angela Cristina Veríssimo Junqueira
Laura Cristina Santos
Alberto Gomes Ferreira
Roberto Cavalleiro de Macedo
author_sort Ana Yecê das Neves Pinto
collection DOAJ
description 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.
first_indexed 2024-12-10T08:40:10Z
format Article
id doaj.art-baf177738f17453d91a4ebbcee3c1132
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-10T08:40:10Z
publishDate 2013-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-baf177738f17453d91a4ebbcee3c11322022-12-22T01:55:52ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0185e6445010.1371/journal.pone.0064450Clinical follow-up of responses to treatment with benznidazol in Amazon: a cohort study of acute Chagas disease.Ana Yecê das Neves PintoVera da Costa ValenteJosé Rodrigues CouraSebastião Aldo da Silva ValenteAngela Cristina Veríssimo JunqueiraLaura Cristina SantosAlberto Gomes FerreiraRoberto Cavalleiro de MacedoA 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.http://europepmc.org/articles/PMC3664625?pdf=render
spellingShingle Ana Yecê das Neves Pinto
Vera da Costa Valente
José Rodrigues Coura
Sebastião Aldo da Silva Valente
Angela Cristina Veríssimo Junqueira
Laura Cristina Santos
Alberto Gomes Ferreira
Roberto Cavalleiro de Macedo
Clinical follow-up of responses to treatment with benznidazol in Amazon: a cohort study of acute Chagas disease.
PLoS ONE
title Clinical follow-up of responses to treatment with benznidazol in Amazon: a cohort study of acute Chagas disease.
title_full Clinical follow-up of responses to treatment with benznidazol in Amazon: a cohort study of acute Chagas disease.
title_fullStr Clinical follow-up of responses to treatment with benznidazol in Amazon: a cohort study of acute Chagas disease.
title_full_unstemmed Clinical follow-up of responses to treatment with benznidazol in Amazon: a cohort study of acute Chagas disease.
title_short Clinical follow-up of responses to treatment with benznidazol in Amazon: a cohort study of acute Chagas disease.
title_sort clinical follow up of responses to treatment with benznidazol in amazon a cohort study of acute chagas disease
url http://europepmc.org/articles/PMC3664625?pdf=render
work_keys_str_mv AT anayecedasnevespinto clinicalfollowupofresponsestotreatmentwithbenznidazolinamazonacohortstudyofacutechagasdisease
AT veradacostavalente clinicalfollowupofresponsestotreatmentwithbenznidazolinamazonacohortstudyofacutechagasdisease
AT joserodriguescoura clinicalfollowupofresponsestotreatmentwithbenznidazolinamazonacohortstudyofacutechagasdisease
AT sebastiaoaldodasilvavalente clinicalfollowupofresponsestotreatmentwithbenznidazolinamazonacohortstudyofacutechagasdisease
AT angelacristinaverissimojunqueira clinicalfollowupofresponsestotreatmentwithbenznidazolinamazonacohortstudyofacutechagasdisease
AT lauracristinasantos clinicalfollowupofresponsestotreatmentwithbenznidazolinamazonacohortstudyofacutechagasdisease
AT albertogomesferreira clinicalfollowupofresponsestotreatmentwithbenznidazolinamazonacohortstudyofacutechagasdisease
AT robertocavalleirodemacedo clinicalfollowupofresponsestotreatmentwithbenznidazolinamazonacohortstudyofacutechagasdisease