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Clinical and laboratory status of patients with chronic Chagas disease living in a vector-controlled area in Minas Gerais, Brazil, before and nine years after aetiological treatment
de Lana, Marta; Lopes, Leonardo A; Martins, Helen R; Bahia, Maria T; Machado-de-Assis, Girley F; Wendling, Ana P; Martins-Filho, Olindo A; Montoya, Roberto A; Dias, João CP; Albajar-Viñas, Pedro & Coura, José R
Abstract
Twenty-eight Chagas disease patients (CD), 22 with the indeterminate clinical form (IND) and six with the cardiac
or digestive form (CARD/DIG), were treated with benznidazole and underwent clinical and laboratorial analysis before
(IND and CARD/DIG) and nine years after [patients after treatment (CDt), patients with the indeterminate clinical
form at treatment onset (INDt) and with the cardiac or digestive form at treatment onset (CARD/DIGt)] treatment.
The data demonstrate that 82.1% of CDt patients (23/28) remained clinically stable and 95.4% of the INDt (21/22)
and 33.3% of the CARD/DIGt (2/6) patients showed unaltered physical and laboratorial examinations. The clinical
evolution rate was 2%/year and was especially low in INDt patients (0.5%/year) relative to CARD/DIGt patients
(7.4%/year). Positive haemoculture in treated patients was observed in 7.1% of the cases. None of the INDt (0/21) and
33.3% of the CARD/DIGt (2/6) patients displayed positive cultures. The PCR presented a positive rate significantly
higher (85.2%, 23/27) than haemoculture and two samples from the same patient revealed the same result 57.7% of the
patients. Conventional serology-ELISA on 16 paired samples remained positive in all individuals. Semi-quantitative
ELISA highlighted significant decreases in reactivity, particularly in INDt relative to IND. Non-conventional serology-
FC-ALTA-IgG, after treatment, showed positive results in all sera and 22 paired samples examined at seven and
nine years after treatment, demonstrated significantly lower reactivity, particularly in INDt patients. This study was
retrospective in nature, had a low number of samples and lacked an intrinsic control group, but the data corroborate
other results found in the literature. The data also demonstrate that, even though a cure has not been detected in the
none-treated patients, the benefits for clinical evolution were selectively observed in the group of INDt patients and
did not occur for CARD/DIGt patients.
Keywords
Chagas disease - aetiological treatment - benznidazole - clinical-laboratorial evaluation - clinical evolution
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