دورية أكاديمية
أعرض في EDS

Five-year serological and clinical evolution of chronic Chagas disease patients in Cochabamba, Bolivia.

التفاصيل البيبلوغرافية
العنوان: Five-year serological and clinical evolution of chronic Chagas disease patients in Cochabamba, Bolivia.
المؤلفون: Pinto J; Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia., Skjefte M; Harvard TH Chan School of Public Health, Department of Global Health and Population, Boston, Massachusetts, United States of America., Alonso-Padilla J; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-University of Barcelona, Barcelona, Spain.; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain., Lozano Beltran DF; Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia.; Universidad Mayor de San Simón, Cochabamba, Bolivia., Pinto LV; Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia., Casellas A; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-University of Barcelona, Barcelona, Spain., Arteaga Terrazas ME; Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia., Toledo Galindo KA; Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia., Challapa Quechover R; Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia., Escobar Caballero M; Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia., Perez Salinas A; Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia., Castellón Jimenez M; Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia., Sanz S; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-University of Barcelona, Barcelona, Spain., Gascón J; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-University of Barcelona, Barcelona, Spain.; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain., Torrico F; Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia.; Universidad Mayor de San Simón, Cochabamba, Bolivia., Pinazo MJ; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-University of Barcelona, Barcelona, Spain.; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain.; Drugs for Neglected Diseases Initiative (DNDi), Geneve, Switzerland.
المصدر: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2023 Dec 29; Vol. 17 (12), pp. e0011498. Date of Electronic Publication: 2023 Dec 29 (Print Publication: 2023).
نوع المنشور: Observational Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101291488 Publication Model: eCollection Cited Medium: Internet ISSN: 1935-2735 (Electronic) Linking ISSN: 19352727 NLM ISO Abbreviation: PLoS Negl Trop Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Chagas Disease*/parasitology , Nitroimidazoles*/therapeutic use , Trypanosoma cruzi* , Trypanocidal Agents*/therapeutic use, Humans ; Bolivia ; Chronic Disease
مستخلص: Background: Chagas disease, caused by the parasite Trypanosoma cruzi, is a neglected infectious disease that exerts the highest public health burden in the Americas. There are two anti-parasitic drugs approved for its treatment-benznidazole and nifurtimox-but the absence of biomarkers to early assess treatment efficacy hinders patients´ follow-up.
Methodology/principal Findings: We conducted a longitudinal, observational study among a cohort of 106 chronically T. cruzi-infected patients in Cochabamba (Bolivia) who completed the recommended treatment of benznidazole. Participants were followed-up for five years, in which we collected clinical and serological data, including yearly electrocardiograms and optical density readouts from two ELISAs (total and recombinant antigens). Descriptive and statistical analyses were performed to understand trends in data, as well as the relationship between clinical symptoms and serological evolution after treatment. Our results showed that both ELISAs documented average declines up to year three and slight inclines for the following two years. The recorded clinical parameters indicated that most patients did not have any significant changes to their cardiac or digestive symptoms after treatment, at least in the timeframe under investigation, while a small percentage demonstrated either a regression or progression in symptoms. Only one participant met the "cure criterion" of a negative serological readout for both ELISAs by the final year.
Conclusions/significance: The study confirms that follow-up of benznidazole-treated T. cruzi-infected patients should be longer than five years to determine, with current tools, if they are cured. In terms of serological evolution, the single use of a total antigen ELISA might be a more reliable measure and suffice to address infection status, at least in the region of Bolivia where the study was done. Additional work is needed to develop a test-of-cure for an early assessment of drugs´ efficacy with the aim of improving case management protocols.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Pinto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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المشرفين على المادة: YC42NRJ1ZD (benzonidazole)
0 (Nitroimidazoles)
0 (Trypanocidal Agents)
تواريخ الأحداث: Date Created: 20231229 Date Completed: 20240103 Latest Revision: 20240104
رمز التحديث: 20240104
مُعرف محوري في PubMed: PMC10756508
DOI: 10.1371/journal.pntd.0011498
PMID: 38157376
قاعدة البيانات: MEDLINE
الوصف
تدمد:1935-2735
DOI:10.1371/journal.pntd.0011498