Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona.
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 biom...
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ftdoajarticles:oai:doaj.org/article:0c055f002ddc4943ad2aedd3541cbf68 2023-05-15T15:13:00+02:00 Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona. Elena Sulleiro Aroa Silgado Núria Serre-Delcor Fernando Salvador Maykon Tavares de Oliveira Zaira Moure Augusto Sao-Aviles Inés Oliveira Begoña Treviño Lidia Goterris Adrián Sánchez-Montalvá Diana Pou Israel Molina Tomàs Pumarola 2020-02-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0008067 https://doaj.org/article/0c055f002ddc4943ad2aedd3541cbf68 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0008067 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008067 https://doaj.org/article/0c055f002ddc4943ad2aedd3541cbf68 PLoS Neglected Tropical Diseases, Vol 14, Iss 2, p e0008067 (2020) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2020 ftdoajarticles https://doi.org/10.1371/journal.pntd.0008067 2022-12-31T05:07:34Z 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 14 2 e0008067 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Elena Sulleiro Aroa Silgado Núria Serre-Delcor Fernando Salvador Maykon Tavares de Oliveira Zaira Moure Augusto Sao-Aviles Inés Oliveira Begoña Treviño Lidia Goterris Adrián Sánchez-Montalvá Diana Pou Israel Molina Tomàs Pumarola Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
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. |
format |
Article in Journal/Newspaper |
author |
Elena Sulleiro Aroa Silgado Núria Serre-Delcor Fernando Salvador Maykon Tavares de Oliveira Zaira Moure Augusto Sao-Aviles Inés Oliveira Begoña Treviño Lidia Goterris Adrián Sánchez-Montalvá Diana Pou Israel Molina Tomàs Pumarola |
author_facet |
Elena Sulleiro Aroa Silgado Núria Serre-Delcor Fernando Salvador Maykon Tavares de Oliveira Zaira Moure Augusto Sao-Aviles Inés Oliveira Begoña Treviño Lidia Goterris Adrián Sánchez-Montalvá Diana Pou Israel Molina Tomàs Pumarola |
author_sort |
Elena Sulleiro |
title |
Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona. |
title_short |
Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona. |
title_full |
Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona. |
title_fullStr |
Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona. |
title_full_unstemmed |
Usefulness of real-time PCR during follow-up of patients treated with Benznidazole for chronic Chagas disease: Experience in two referral centers in Barcelona. |
title_sort |
usefulness of real-time pcr during follow-up of patients treated with benznidazole for chronic chagas disease: experience in two referral centers in barcelona. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2020 |
url |
https://doi.org/10.1371/journal.pntd.0008067 https://doaj.org/article/0c055f002ddc4943ad2aedd3541cbf68 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 14, Iss 2, p e0008067 (2020) |
op_relation |
https://doi.org/10.1371/journal.pntd.0008067 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008067 https://doaj.org/article/0c055f002ddc4943ad2aedd3541cbf68 |
op_doi |
https://doi.org/10.1371/journal.pntd.0008067 |
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PLOS Neglected Tropical Diseases |
container_volume |
14 |
container_issue |
2 |
container_start_page |
e0008067 |
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1766343614392172544 |