Open AccessUsefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona
Author(s) -
Elena Sulleiro,
Aroa Silgado,
Núria Serre-Delcor,
Fernando Salvador,
Maykon Tavares de Oliveira,
Zaira Moure,
Augusto Sao-Avilés,
Inês Oliveira,
Begoña Treviño,
Lidia Goterris,
Adrián Sánchez-Montalvà,
Diana Pou,
Israel Molina,
Tomàs Pumarola
Publication year - 2020
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0008067
Subject(s) - benznidazole , medicine , nifurtimox , chagas disease , discontinuation , cohort , asymptomatic , parasitemia , immunology , trypanosoma cruzi , parasite hosting , world wide web , computer science , plasmodium falciparum , malaria
Background Antitrypanosomal treatment with Benznidazole (BZ) or Nifurtimox may be recommended for patients with chronic Chagas disease (CD) to reduce the onset or progression of symptoms. However, such treatment has limited efficacy and high level of toxic effects. In addition, the current cure biomarker (serology conversion) precludes any treatment assessment unless a prolonged follow-up is arranged. PCR is thus the most useful, alternative surrogate marker for evaluating responses to treatment. The aim of this study is to describe the usefulness of real-time PCR in monitoring BZ treatment within a large cohort of chronic CD cases in Barcelona. Methodology/Principal findings A total of 370 chronic CD patients were monitored with real-time PCR post-BZ treatment. The median follow-up was 4 years (IQR 2.2–5.3y), with a median of 3 clinical visits (IQR 2–4). Only 8 patients (2.2%) presented with at least one incident of positive real-time PCR after treatment and were therefore considered as treatment failure. Four of those failure patients had completed full course treatment, whereas the remaining cases had defaulted with a statistical difference between both groups (p = 0.02). Half of the failure patients had undergone less than 4 years of follow-up monitoring all presented with parasitemia before treatment. Conclusions/Significance BZ treatment failure was highly infrequent in our cohort. BZ discontinuation was a risk factor for positive real-time PCR results during clinical follow-up. Regular testing with real-time PCR during follow-up allows for early detection of treatment failure in patients with chronic CD.