Abstract | OBJECTIVES: METHODS: In March 1992, we treated 46 patients with chronic Chagas' disease with 6 mg/kg/day of itraconazole for 120 days in a blind evaluation. The patients came from an area of Chile where the disease was endemic and were checked for ECG abnormalities and with xenodiagnosis (XD) or real-time XD-quantitative PCR (XD-qPCR) for Trypanosoma cruzi infection before treatment and once a year for 20 years. RESULTS: Twenty-one patients proved to be uninfected after 20 years and 15 of the patients had a normal ECG. Of the latter cases, 32.6% could be considered cured, although all of them had positive serology. Itraconazole prevents the development of ECG abnormalities, because after 20 years of treatment only 10.86% of patients developed ECG abnormalities (Zā=ā1.70, Pā=ā0.046). XD-qPCR performed on 16 patients demonstrated 10 cases with <1.42 parasites/mL: eight with <1 parasite/mL, one with 1.42 parasites/mL and one with 1.01 parasites/mL. Five patients had more than 11.75 parasites/mL, all of them with a positive XD; these cases correspond to therapy failure, since re-infection was ruled out. In one case, XD-qPCR did not present amplification. CONCLUSIONS:
Itraconazole is useful in the treatment of chronic Chagas' disease as it prevented the development of ECG abnormalities and cured 32.6% of patients.
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Authors | Werner Apt, Arturo Arribada, Inés Zulantay, Jorge Rodríguez, Miguel Saavedra, Andrea Muñoz |
Journal | The Journal of antimicrobial chemotherapy
(J Antimicrob Chemother)
Vol. 68
Issue 9
Pg. 2164-9
(Sep 2013)
ISSN: 1460-2091 [Electronic] England |
PMID | 23645584
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antiprotozoal Agents
- Itraconazole
|
Topics |
- Antiprotozoal Agents
(administration & dosage)
- Chagas Disease
(drug therapy, parasitology, pathology)
- Chile
- Electrocardiography
- Follow-Up Studies
- Humans
- Itraconazole
(administration & dosage)
- Parasitology
- Time Factors
- Treatment Outcome
- Trypanosoma cruzi
(drug effects, isolation & purification)
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