1921
Volume 73, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

DNA was amplified from an intracranial biopsy and peripheral blood of an HIV patient with encephalitis; this episode was indicative of AIDS and congenital Chagas disease. The analysis of a micro-satellite locus revealed a multiclonal parasite population at the brain lesion with a more complex minicircle signature than that profiled in blood using restriction fragment length polymorphism (RFLP)-PCR and low stringency single primer (LSSP) PCR. Interestingly, different sublineages of II were detected in blood and brain by means of spliced-leader and 24sα ribosomal-DNA amplifications. Quantitative-competitive PCR monitored the decrease of parasitic load during treatment and secondary prophylaxis with benznidazole. The synergy between parasiticidal plus anti-retroviral treatments probably allowed the patient a longer survival than usually achieved in similar episodes. This is the first case report demonstrating a differential distribution of natural parasite populations and sublineages in Chagas disease reactivation, showing the proliferation of cerebral variants not detectable in peripheral blood.

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2005-12-01
2017-11-20
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References

  1. Gurtler RE, Segura EL, Cohen JE, 2003. Congenital transmission of Trypanosoma cruzi infection in Argentina. Emerg Infect Dis 9 : 29–32.
  2. Freilij H, Altcheh J, 1995. Congenital Chagas’ disease. Diagnostic and clinical aspects. Clin Inf Dis 21 : 551–555.
  3. Corti M, 2000. AIDS and Chagas disease. AIDS Patient Care STDs 14 : 581–588.
  4. Cahn P, Badaró R, Freilij H, 2001. Other parasitic infections. Crowe S, Hoy J, Mills J, eds. Management of the HIV-Infected Patient. 2nd ed. Taylor & Francis Group, London, U.K., 31: 513–525.
  5. Macedo AM, Pena SDJ, 1998. Genetic variability of Trypanosoma cruzi: implications for the pathogenesis of Chagas disease. Parasitol Today 14 : 119–123.
  6. Macedo AM, Machado CR, Oliveira R, Pena SDJ, 2004. Trypanosoma cruzi: genetic structure of populations and relevance of genetic variability to the pathogenesis of Chagas disease. Mem Inst Oswaldo Cruz 99 : 1–12.
  7. Anonymous, 1999. Recommendations from a satellite meeting. Mem Inst Oswaldo Cruz 94 : 429–432.
  8. Brisse S, Barnabe C, Tibayrenc M, 2000. Identification of six Trypanosoma cruzi phylogenetic lineages by random amplified polymorphic DNA and multilocus enzyme electrophoresis. Int J Parasitol 30 : 35–44.
  9. Macedo AM, Pimenta JR, Aguiar RS, Melo AIR, Chiari E, Zingales B, Pena SDJ, Oliveira RP, 2001. Usefulness of microsatellite typing in population genetic studies of T. cruzi. Mem Inst Oswaldo Cruz 96 : 407–413.
  10. Vago AR, Macedo AM, Oliveira RP, Andrade LO, Chiari E, Galvao LM, Reis D, Pereira ME, Simpson AJ, Tostes S, Pena SD, 1996. Kinetoplast DNA signatures of Trypanosoma cruzi strains obtained directly from infected tissues. Am J Pathol 149 : 2153–2159.
  11. Solari A, Munoz S, Venegas J, Wallace A, Aguilera X, Apt W, Breniere SF, Tibayrenc M, 1992. Characterization of Chilean, Bolivian, and Argentinian Trypanosoma cruzi populations by restriction endonuclease and isoenzyme analysis. Exp Parasitol 75 : 187–195.
  12. Ho-Yen DO, Joss AW, Balfour AH, Smyth ET, Baird D, Chatterton JM, 1992. Use of the polymerase chain reaction to detect Toxoplasma gondii in human blood samples. J Clin Pathol 45 : 910–913.
  13. Schijman AG, Altcheh J, Burgos JM, Biancardi M, Bisio M, Levin MJ, Freilij H, 2003. Aetiological treatment of congenital Chagas’ disease diagnosed and monitored by the polymerase chain reaction. J Antimicrob Chemother 52 : 441–449.
  14. Schijman AG, Vigliano C, Burgos J, Favaloro R, Perrone S, Laguens R, Levin MJ, 2000. Early diagnosis of recurrence of Trypanosoma cruzi infection by polymerase chain reaction after heart transplantation of a chronic Chagas’ heart disease patient. J Heart Lung Transplant 19 : 1114–1117.
  15. Souto RP, Fernandes O, Macedo AM, Campbell DA, Zingales B, 1996. DNA markers define two major phylogenetic lineages of Trypanosoma cruzi. Mol Biochem Parasitol 83 : 141–152.
  16. Perez-Ramirez L, Barnabe C, Sartori AM, Ferreira MS, Tolezano JE, Nunes EV, Burgarelli MK, Silva AC, Shikanai-Yasuda MA, Lima JN, Da-Cruz AM, Oliveira OC, Guilherme C, Bastrenta B, Tibayrenc M, 1999. Clinical analysis and parasite genetic diversity in human immunodeficiency virus/ Chagas’ disease coinfections in Brazil. Am J Trop Med Hyg 61 : 198–206.
  17. Sartori AM, Caiaffa-Filho HH, Bezerra RC, Do S, Guilherme C, Lopes MH, Shikanai-Yasuda MA, 2002. Exacerbation of HIV viral load simultaneous with asymptomatic reactivation of chronic Chagas’ disease. Am J Trop Med Hyg 67 : 521–523.
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  • Received : 09 Jun 2005
  • Accepted : 08 Jul 2005

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