Real-Time PCR in HIV/Trypanosoma cruzi Coinfection with and without Chagas Disease Reactivation: Association with HIV Viral Load and CD4+ Level

Chagas disease is endemic in Latin America and is caused by the flagellate protozoan T. cruzi. The acute phase is asymptomatic in the majority of the cases and rarely causes inflammation of the heart or the central nervous system. Most infected patients progress to a chronic phase, characterized by cardiac or digestive involvement when not asymptomatic. However, when patients are also exposed to an immunosuppressant (such as chemotherapy), neoplasia, or other infections such as HIV, T. cruzi infection may develop into a severe disease (Chagas disease reactivation) involving the heart and central nervous system. The current microscopic methods for diagnosing Chagas disease reactivation are not sensitive enough to prevent the high rate of death observed in these cases. Therefore, we propose a quantitative method to monitor blood levels of the parasite, which will allow therapy to be administered as early as possible, even if the patient has not yet presented symptoms

Usefulness of PCR-based assays to assess drug efficacy in Chagas disease chemotherapy: value and limitations

One major goal of research on Chagas disease is the development of effective chemotherapy to eliminate the infection from individuals who have not yet developed cardiac and/or digestive disease manifestations. Cure evaluation is the more complex aspect of its treatment, often leading to diverse and controversial results. The absence of reliable methods or a diagnostic gold standard to assess etiologic treatment efficacy still constitutes a major challenge. In an effort to develop more sensitive tools, polymerase chain reaction (PCR)-based assays were introduced to detect low amounts of Trypanosoma cruzi DNA in blood samples from chagasic patients, thus improving the diagnosis and follow-up evaluation after chemotherapy. In this article, I review the main problems concerning drug efficacy and criteria used for cure estimation in treated chagasic patients, and the work conducted by different groups on developing PCR methodologies to monitor treatment outcome of congenital infections as well as recent and late chronic T. cruzi infections

Populational heterogeneity of Brazilian Trypanosoma cruzi isolates revealed by the mini-exon and ribosomal spacers

Submitted by Sandra Infurna ([email protected]) on 2020-06-06T14:35:04Z No. of bitstreams: 1 ElisaCupolillo_OFernandes_etal_IOC_1999.pdf: 107007 bytes, checksum: 9dafb12dcf2b6de94155f66c5a98c6de (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2020-06-06T15:02:24Z (GMT) No. of bitstreams: 1 ElisaCupolillo_OFernandes_etal_IOC_1999.pdf: 107007 bytes, checksum: 9dafb12dcf2b6de94155f66c5a98c6de (MD5)Made available in DSpace on 2020-06-06T15:02:24Z (GMT). No. of bitstreams: 1 ElisaCupolillo_OFernandes_etal_IOC_1999.pdf: 107007 bytes, checksum: 9dafb12dcf2b6de94155f66c5a98c6de (MD5) Previous issue date: 1999Universidade do Estado do Rio de Janeiro Departamento de Patologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Protozoologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Protozoologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Protozoologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Imunologia. Rio de Janeiro, RJ, Brasil.University of California. School of Medicine Department of Microbiology and Immunology. Los Angeles, CA, USA.Universidade de São Paulo. Instituto de Química. Departamento de Bioquímica. São Paulo, SP, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil

Assessment of chemiluminescence and PCR effectiveness in relation to conventional serological tests for the diagnosis of Chagas' disease Avaliação da eficiência da quimiluminescência e PCR em relação aos testes sorológicos convencionais para o diagnóstico da doença de Chagas

While testing 414 sera for the diagnosis of Chagas' disease, the conventional reactions of indirect hemagglutination, indirect immunofluorescence and the immunosorbent assay showed a sensitivity of 95.7%, 100% and 98.2% and a specificity of 98%, 98% and 96.4%, respectively, and an excellent association using Fisher's exact test. Chemiluminescence presented 100% sensitivity and 89.6% specificity, while PCR showed 100% specificity and 1.2% sensitivity. It is believed that the three conventional serological reactions are still adequate for diagnosing Chagas' disease.<br>No exame de 414 soros, para o diagnóstico da doença de Chagas, as reações convencionais de hemaglutinação indireta, imunofluorescência indireta e o ensaio imunoenzimático mostraram, respectivamente, uma sensibilidade de 95,7%, 100% e 98,2% e uma especificidade de 98%, 98% e 96,4% e excelente associação usando teste exato de Fisher. A quimioluminescência apresentou 100% de sensibilidade, 89,6% de especificidade e a PCR 100% de especificidade e 1,2% de sensibilidade. Acredita-se que as três reações sorológicas convencionais ainda são suficientes para o diagnóstico da doença de Chagas