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POLYMERASE CHAIN REACTION DETECTION AND SEROLOGIC FOLLOW-UP AFTER TREATMENT WITH BENZNIDAZOLE IN BOLIVIAN CHILDREN INFECTED WITH A NATURAL MIXTURE OF TRYPANOSOMA CRUZI I AND II

Thirty-five Bolivian children (5–10 years of age) seropositive for infection with T. cruzi underwent specific chemotherapy with benznidazole. Before treatment, 57.1% had a positive parasitologic diagnosis. Some patients presented an early conversion by polymerase chain reaction of blood samples, while others were still positive four and seven months after the end of the treatment, which indicated an absence of parasite clearance. Strain typing showed that most patients were infected by a mixture of clones I and II of T. cruzi. Serologic conversion in conventional tests and antibodies to shed acute-phase antigen were observed in two and four patients, respectively. For the other patients, the average rate of antibody decay was half the initial rate. The parasitologic and serologic data indicated that chemotherapy acts throughout the course of infection in a long-lasting process in which the decrease of specific antibody production is related to the reduction of the live parasite load.

Received February 25, 2005. Accepted for publication October 31, 2005.

Acknowledgments: We thank Daniel Sanchez (Fundación Campomar, Buenos Aires, Argnetina) for providing SAPA recombinant protein, the personnel of the Harry Williams Hospital in Cocha-bamba for medical assistance during the treatment of the children, and Shirley Longacre (Laboratory of Vaccinologie Parasitaire, Institut Pasteur, Paris, France) for help with the English revision of the manuscript.

Financial support: This research was supported by the World Health Organization Special Program for Research and Training in Tropical Disease (ID 940856) and the Institut de Recherche pour le Développement, France.

^* Address correspondence to Simone Frédérique Brenière, Unite de Recherche 008 Pathogénie des Trypanosomatidés, Institut de Recherche pour le Développement, 911 Avenue Agropolis, BP 5045, 34032 Montpellier Cedex 1, France. E-mail: breniere{at}mpl.ird.fr

Authors’ addresses: Maria Flores-Chavez, Jose-Louis Alcazar Dalenz, and Susana Revollo, Facultad de Ciencias Farmacéuticas y Bioquímicas, Instituto Seladis, Universidad Mayor de San Andrés, Saavedra No. 2224, La Paz, Bolivia. Marie-France Bosseno, Brigitte Bastrenta, and Simone Frédérique Brenière, Unité de Recherche 008 Pathogénie des Trypanosomatidés, Institut de Recherche pour le Développement, 911 Avenue Agropolis, BP 5045, 34032 Montpellier Cedex 1, France, Telephone: 33-4-67-41-62-98, Fax: 33-4-67-41-63-30, E-mail: breniere{at}mpl.ird.fr. Mireille Hontebeyrie, Institut Pasteur, 28, Rue du Dr. Roux, Paris 15, France, E-mail: mhj{at}pasteur.fr.