Andrés Guillermo Benchetrit1, Marisa Fernández2, Amadeo Javier Bava3, Marcelo Corti3, Norma Porteiro3, Liliana Martínez Peralta4. 1. Hospital de Enfermedades Infecciosas Dr. Francisco J. Muñiz, Zip Code 1282, Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: abenchetrit@buenosaires.gob.ar. 2. Hospital de Enfermedades Infecciosas Dr. Francisco J. Muñiz, Zip Code 1282, Ciudad Autónoma de Buenos Aires, Argentina; Departamento de Clínica, Patología y Tratamiento, Instituto Nacional de Parasitología Dr. M. Fatala Chaben, ANLIS Dr. C.G. Malbran, Zip Code 1063, Ciudad Autónoma de Buenos Aires, Argentina. 3. Hospital de Enfermedades Infecciosas Dr. Francisco J. Muñiz, Zip Code 1282, Ciudad Autónoma de Buenos Aires, Argentina. 4. Instituto de Investigaciones en Microbiología y Parasitología Médica, Universidad de Buenos Aires-Consejo Nacional de Investigaciones Científicas y Tecnológicas (IMPaM, UBA-CONICET), Zip Code 1121, Ciudad Autónoma de Buenos Aires, Argentina.
Abstract
OBJECTIVES: Trypanosoma cruzi reactivation in HIV patients is considered an opportunistic infection, usually with a fatal outcome. The aim of this study was to describe the epidemiological and clinical features of T. cruzi infection in HIV patients and to compare these findings between patients with and without Chagas disease reactivation. METHODS: The medical records of T. cruzi-HIV co-infected patients treated at the Muñiz Infectious Diseases Hospital from January 2005 to December 2014 were reviewed retrospectively. Epidemiological and clinical features were assessed and compared between patients with and without Chagas disease reactivation. RESULTS: The medical records of 80 T. cruzi-HIV co-infected patients were reviewed. The most likely route of T. cruzi infection was vector-borne (32/80 patients), followed by intravenous drug use (12/80). Nine of 80 patients had reactivation. Patients without reactivation had a significantly higher CD4 T-cell count at diagnosis of T. cruzi infection (144 cells/μl vs. 30 cells/μl, p=0.026). Chagas disease serology was negative in two of nine patients with reactivation. CONCLUSIONS: Serological assays for T. cruzi infection may be negative in severely immunocompromised patients. Direct parasitological techniques should be performed in the diagnosis of patients for whom there is a suspicion of T. cruzi reactivation. HIV patients with a lower CD4 count are at higher risk of reactivation.
OBJECTIVES:Trypanosoma cruzi reactivation in HIVpatients is considered an opportunistic infection, usually with a fatal outcome. The aim of this study was to describe the epidemiological and clinical features of T. cruzi infection in HIVpatients and to compare these findings between patients with and without Chagas disease reactivation. METHODS: The medical records of T. cruzi-HIV co-infectedpatients treated at the Muñiz Infectious Diseases Hospital from January 2005 to December 2014 were reviewed retrospectively. Epidemiological and clinical features were assessed and compared between patients with and without Chagas disease reactivation. RESULTS: The medical records of 80 T. cruzi-HIV co-infectedpatients were reviewed. The most likely route of T. cruzi infection was vector-borne (32/80 patients), followed by intravenous drug use (12/80). Nine of 80 patients had reactivation. Patients without reactivation had a significantly higher CD4 T-cell count at diagnosis of T. cruzi infection (144 cells/μl vs. 30 cells/μl, p=0.026). Chagas disease serology was negative in two of nine patients with reactivation. CONCLUSIONS: Serological assays for T. cruzi infection may be negative in severely immunocompromised patients. Direct parasitological techniques should be performed in the diagnosis of patients for whom there is a suspicion of T. cruzi reactivation. HIVpatients with a lower CD4 count are at higher risk of reactivation.
Authors: Gláucia Elisete Barbosa Marcon; Juliana de Jesus Guimarães Ferreira; Eros Antonio de Almeida; Adriane Maira Delicio; Mariane Barroso Pereira; Jamiro da Silva Wanderley; Luiz Cláudio Martins; Paula Durante Andrade; Rodrigo Gonçalves de Lima; Sandra Cecília Botelho Costa Journal: PLoS Negl Trop Dis Date: 2022-03-30