Parasite load evaluation by qPCR and blood culture in Chagas disease and HIV co-infected patients under antiretroviral therapy

Chagas disease also known as American trypanosomiasis, is caused by Trypanosoma cruzi and transmitted by triatominae-contaminated feces. It is considered a neglected tropical disease that affects 6 to 7 million people worldwide. The reactivation of Chagas disease occurs when the chronically infected...

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Veröffentlicht in:PLoS neglected tropical diseases 2022-03, Vol.16 (3), p.e0010317-e0010317
Hauptverfasser: Marcon, Gláucia Elisete Barbosa, Ferreira, Juliana de Jesus Guimarães, de Almeida, Eros Antonio, Delicio, Adriane Maira, Pereira, Mariane Barroso, Wanderley, Jamiro da Silva, Martins, Luiz Cláudio, Andrade, Paula Durante, de Lima, Rodrigo Gonçalves, Costa, Sandra Cecília Botelho
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container_issue 3
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container_title PLoS neglected tropical diseases
container_volume 16
creator Marcon, Gláucia Elisete Barbosa
Ferreira, Juliana de Jesus Guimarães
de Almeida, Eros Antonio
Delicio, Adriane Maira
Pereira, Mariane Barroso
Wanderley, Jamiro da Silva
Martins, Luiz Cláudio
Andrade, Paula Durante
de Lima, Rodrigo Gonçalves
Costa, Sandra Cecília Botelho
description Chagas disease also known as American trypanosomiasis, is caused by Trypanosoma cruzi and transmitted by triatominae-contaminated feces. It is considered a neglected tropical disease that affects 6 to 7 million people worldwide. The reactivation of Chagas disease occurs when the chronically infected hosts are not able to control T. cruzi infection, generating recurrence of the acute phase. HIV is the main immunosuppressive infection that can lead to the reactivation of chronic Chagas disease in AIDS conditions. In co-infected patients, the reactivation of Chagas disease is related to their high parasite load, high HIV viral load, and CD4 T-cell counting less than 200/mm3, which may evolve to meningoencephalitis and myocarditis. Eight T. cruzi/HIV co-infected patients under antiretroviral therapy (ART) and ten Chagas disease patients without HIV infection that attended at Study Group of Chagas Disease, Hospital de Clínicas, University of Campinas (GEdoCh/HC/UNICAMP-SP) and Pontifical Catholic University of Campinas SP (PUCC/SP) were evaluated. Tests for Chagas disease were performed, such as qPCR and T. cruzi blood culture. The patient's medical records were analyzed to verify clinical and epidemiological data, viral load, and CD4 T-cell counting since the outset of ART. For both groups, we found no statically significant differences between parasite load via blood culture and qPCR. In T. cruzi/HIV co-infected subjects, we observed a significant increase of CD4 T-cells counting and viral load decrease, which became undetectable over the years after ART. Parasites isolated from the patient's blood culture were genotyped, being the majority of them infected with TcII and one case of mixed infection (TcII and TcV/TcVI). These results were expected according to the region of origin of the patients. We suggest that the parasite load be monitored through qPCR in T.cruzi/HIV co-infected patients. We conclude that ART in people living with HIV improves infection and immunosuppression control, enabling the natural evolution of the American trypanosomiasis.
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It is considered a neglected tropical disease that affects 6 to 7 million people worldwide. The reactivation of Chagas disease occurs when the chronically infected hosts are not able to control T. cruzi infection, generating recurrence of the acute phase. HIV is the main immunosuppressive infection that can lead to the reactivation of chronic Chagas disease in AIDS conditions. In co-infected patients, the reactivation of Chagas disease is related to their high parasite load, high HIV viral load, and CD4 T-cell counting less than 200/mm3, which may evolve to meningoencephalitis and myocarditis. Eight T. cruzi/HIV co-infected patients under antiretroviral therapy (ART) and ten Chagas disease patients without HIV infection that attended at Study Group of Chagas Disease, Hospital de Clínicas, University of Campinas (GEdoCh/HC/UNICAMP-SP) and Pontifical Catholic University of Campinas SP (PUCC/SP) were evaluated. Tests for Chagas disease were performed, such as qPCR and T. cruzi blood culture. The patient's medical records were analyzed to verify clinical and epidemiological data, viral load, and CD4 T-cell counting since the outset of ART. For both groups, we found no statically significant differences between parasite load via blood culture and qPCR. In T. cruzi/HIV co-infected subjects, we observed a significant increase of CD4 T-cells counting and viral load decrease, which became undetectable over the years after ART. Parasites isolated from the patient's blood culture were genotyped, being the majority of them infected with TcII and one case of mixed infection (TcII and TcV/TcVI). These results were expected according to the region of origin of the patients. We suggest that the parasite load be monitored through qPCR in T.cruzi/HIV co-infected patients. We conclude that ART in people living with HIV improves infection and immunosuppression control, enabling the natural evolution of the American trypanosomiasis.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0010317</identifier><identifier>PMID: 35353834</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; AIDS ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Antiviral agents ; Biology and Life Sciences ; Blood ; Blood Culture ; Care and treatment ; CD4 antigen ; Cell culture ; Chagas disease ; Chagas Disease - complications ; Chagas Disease - drug therapy ; Chagas Disease - parasitology ; Chronic infection ; Coinfection - parasitology ; Complications and side effects ; Diagnostic tests ; Disease prevention ; Dosage and administration ; Drug therapy ; Encephalitis ; Epidemiology ; Evaluation ; Heart diseases ; HIV ; HIV infection ; HIV Infections - complications ; HIV Infections - drug therapy ; Hospitals ; Human immunodeficiency virus ; Humans ; Immune system ; Immunosuppression ; Infections ; Laboratories ; Lymphocytes T ; Medical records ; Medicine and Health Sciences ; Meningitis ; Meningoencephalitis ; Methods ; Mixed infection ; Myocarditis ; Parasite Load ; Parasites ; Patients ; Polymerase chain reaction ; Protozoa ; Public health ; Risk factors ; Serology ; Therapy ; Tropical climate ; Tropical diseases ; Trypanosoma cruzi ; Trypanosomiasis ; Vector-borne diseases</subject><ispartof>PLoS neglected tropical diseases, 2022-03, Vol.16 (3), p.e0010317-e0010317</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Marcon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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It is considered a neglected tropical disease that affects 6 to 7 million people worldwide. The reactivation of Chagas disease occurs when the chronically infected hosts are not able to control T. cruzi infection, generating recurrence of the acute phase. HIV is the main immunosuppressive infection that can lead to the reactivation of chronic Chagas disease in AIDS conditions. In co-infected patients, the reactivation of Chagas disease is related to their high parasite load, high HIV viral load, and CD4 T-cell counting less than 200/mm3, which may evolve to meningoencephalitis and myocarditis. Eight T. cruzi/HIV co-infected patients under antiretroviral therapy (ART) and ten Chagas disease patients without HIV infection that attended at Study Group of Chagas Disease, Hospital de Clínicas, University of Campinas (GEdoCh/HC/UNICAMP-SP) and Pontifical Catholic University of Campinas SP (PUCC/SP) were evaluated. Tests for Chagas disease were performed, such as qPCR and T. cruzi blood culture. The patient's medical records were analyzed to verify clinical and epidemiological data, viral load, and CD4 T-cell counting since the outset of ART. For both groups, we found no statically significant differences between parasite load via blood culture and qPCR. In T. cruzi/HIV co-infected subjects, we observed a significant increase of CD4 T-cells counting and viral load decrease, which became undetectable over the years after ART. Parasites isolated from the patient's blood culture were genotyped, being the majority of them infected with TcII and one case of mixed infection (TcII and TcV/TcVI). These results were expected according to the region of origin of the patients. We suggest that the parasite load be monitored through qPCR in T.cruzi/HIV co-infected patients. We conclude that ART in people living with HIV improves infection and immunosuppression control, enabling the natural evolution of the American trypanosomiasis.</description><subject>Acquired immune deficiency syndrome</subject><subject>AIDS</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Antiviral agents</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Blood Culture</subject><subject>Care and treatment</subject><subject>CD4 antigen</subject><subject>Cell culture</subject><subject>Chagas disease</subject><subject>Chagas Disease - complications</subject><subject>Chagas Disease - drug therapy</subject><subject>Chagas Disease - parasitology</subject><subject>Chronic infection</subject><subject>Coinfection - parasitology</subject><subject>Complications and side effects</subject><subject>Diagnostic tests</subject><subject>Disease prevention</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Encephalitis</subject><subject>Epidemiology</subject><subject>Evaluation</subject><subject>Heart diseases</subject><subject>HIV</subject><subject>HIV infection</subject><subject>HIV Infections - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marcon, Gláucia Elisete Barbosa</au><au>Ferreira, Juliana de Jesus Guimarães</au><au>de Almeida, Eros Antonio</au><au>Delicio, Adriane Maira</au><au>Pereira, Mariane Barroso</au><au>Wanderley, Jamiro da Silva</au><au>Martins, Luiz Cláudio</au><au>Andrade, Paula Durante</au><au>de Lima, Rodrigo Gonçalves</au><au>Costa, Sandra Cecília Botelho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Parasite load evaluation by qPCR and blood culture in Chagas disease and HIV co-infected patients under antiretroviral therapy</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>16</volume><issue>3</issue><spage>e0010317</spage><epage>e0010317</epage><pages>e0010317-e0010317</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Chagas disease also known as American trypanosomiasis, is caused by Trypanosoma cruzi and transmitted by triatominae-contaminated feces. It is considered a neglected tropical disease that affects 6 to 7 million people worldwide. The reactivation of Chagas disease occurs when the chronically infected hosts are not able to control T. cruzi infection, generating recurrence of the acute phase. HIV is the main immunosuppressive infection that can lead to the reactivation of chronic Chagas disease in AIDS conditions. In co-infected patients, the reactivation of Chagas disease is related to their high parasite load, high HIV viral load, and CD4 T-cell counting less than 200/mm3, which may evolve to meningoencephalitis and myocarditis. Eight T. cruzi/HIV co-infected patients under antiretroviral therapy (ART) and ten Chagas disease patients without HIV infection that attended at Study Group of Chagas Disease, Hospital de Clínicas, University of Campinas (GEdoCh/HC/UNICAMP-SP) and Pontifical Catholic University of Campinas SP (PUCC/SP) were evaluated. Tests for Chagas disease were performed, such as qPCR and T. cruzi blood culture. The patient's medical records were analyzed to verify clinical and epidemiological data, viral load, and CD4 T-cell counting since the outset of ART. For both groups, we found no statically significant differences between parasite load via blood culture and qPCR. In T. cruzi/HIV co-infected subjects, we observed a significant increase of CD4 T-cells counting and viral load decrease, which became undetectable over the years after ART. Parasites isolated from the patient's blood culture were genotyped, being the majority of them infected with TcII and one case of mixed infection (TcII and TcV/TcVI). These results were expected according to the region of origin of the patients. We suggest that the parasite load be monitored through qPCR in T.cruzi/HIV co-infected patients. We conclude that ART in people living with HIV improves infection and immunosuppression control, enabling the natural evolution of the American trypanosomiasis.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>35353834</pmid><doi>10.1371/journal.pntd.0010317</doi><orcidid>https://orcid.org/0000-0003-0276-4285</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1935-2735
ispartof PLoS neglected tropical diseases, 2022-03, Vol.16 (3), p.e0010317-e0010317
issn 1935-2735
1935-2727
1935-2735
language eng
recordid cdi_plos_journals_2651150438
source MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access; Public Library of Science (PLoS)
subjects Acquired immune deficiency syndrome
AIDS
Antiretroviral agents
Antiretroviral drugs
Antiretroviral therapy
Antiviral agents
Biology and Life Sciences
Blood
Blood Culture
Care and treatment
CD4 antigen
Cell culture
Chagas disease
Chagas Disease - complications
Chagas Disease - drug therapy
Chagas Disease - parasitology
Chronic infection
Coinfection - parasitology
Complications and side effects
Diagnostic tests
Disease prevention
Dosage and administration
Drug therapy
Encephalitis
Epidemiology
Evaluation
Heart diseases
HIV
HIV infection
HIV Infections - complications
HIV Infections - drug therapy
Hospitals
Human immunodeficiency virus
Humans
Immune system
Immunosuppression
Infections
Laboratories
Lymphocytes T
Medical records
Medicine and Health Sciences
Meningitis
Meningoencephalitis
Methods
Mixed infection
Myocarditis
Parasite Load
Parasites
Patients
Polymerase chain reaction
Protozoa
Public health
Risk factors
Serology
Therapy
Tropical climate
Tropical diseases
Trypanosoma cruzi
Trypanosomiasis
Vector-borne diseases
title Parasite load evaluation by qPCR and blood culture in Chagas disease and HIV co-infected patients under antiretroviral therapy
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