Antitrypanosomal therapy for chronic Chagas' disease.

GARCIA-BOURNISSEN F; ALTCHEH J

NEW ENGLAND JOURNAL OF MEDICINE

MASSACHUSETTS MEDICAL SOC

Año: 2011 vol. 365 p. 1258 - 1259

0028-4793

We would like to offer a few comments regarding the Clinical Therapeutics article on Chagas? disease by Bern (June 30 issue). 1 Currently, the only clear hope for curing Chagas? disease is the treatment of infected children as early as possible, thus preventing illness and death in adults. This early treatment is especially important considering that older patients have a poor response to treatment and have significantly more adverse events than children.2 In our pediatric pharmacokinetics study of benznidazole in Chagas? disease,3 we observed significantly lower blood concentrations of the drug in children than those reported in adults receiving the same dose per kilogram of body weight, suggesting that lower clearance of benznidazole in adults leads to drug accumulation and a higher rate of adverse events. Congenital transmission of Chagas? disease is a major route of transmission worldwide.4 Assuming an average rate of congenital infection of approximately 200 to 300 newborns per year in the United States,5 the estimated current prevalence of congenitally infected U.S. children younger than 18 years of age would be 1 case in 80,000 children. Considering that one third of these patients will have heart complications if not treated, a more syste