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

Alta parasitemia pelo Trypanosoma cruzi em paciente com lupus eritematoso sistêmico Trypanosoma cruzi high parasitemia in patient with systemic lupus erythematosus

É descrito um caso de doença de Chagas com alta parasitemia pelo Trypanosoma cruzi em paciente com lupus eritematoso sistêmico. O xenodiagnóstico foi útil na identificação da parasitemia e o benznidazol foi capaz de reduzir a alta e incomum parasitemia. Em indivíduos com doenças auto-imunes e immunossuprimidos, o benznidazol pode ser uma alternativa no controle da alta parasitemia por Trypanosoma cruzi.<br>A case of Trypanosoma cruzi high parasitemia in patient with systemic lupus erythematosus is reported. A xenodiagnostic test was useful in the identification of high and uncommon parasitemia, and Benznidazole was able to reduce the parasitemia. Benznidazole can be an alternative to control the Trypanosoma cruzi high parasitemia in people with autoimmune disease and immunosuppression