Molecular diagnosis and typing of Trypanosoma cruzi populations and lineages in cerebral Chagas disease in a patient with AIDS

BURGOS JM; BEGHER SB; FREITAS JM; BISIO M; DUFFY T; ALTCHEH J; TEIJEIRO R; LOPEZ ALCOBA H; DECCARLINI F; FREILIJ H; LEVIN MJ; LEVALLE J; MACEDO AM; SCHIJMAN AG

AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE

AMER SOC TROP MED & HYGIENE

Lugar: Stanford; Año: 2005 vol. 73 p. 1016 - 1018

0002-9637

Trypanosoma cruzi DNA was amplified from an intracranial biopsy and peripheralblood of an HIV patient with encephalitis; this episode was indicative of AIDSand congenital Chagas disease. The analysis of a micro-satellite locus revealed amulticlonal parasite population at the brain lesion with a more complexminicircle signature than that profiled in blood using restriction fragmentlength polymorphism (RFLP)-PCR and low stringency single primer (LSSP) PCR.Interestingly, different sublineages of T. cruzi II were detected in blood andbrain by means of spliced-leader and 24salpha ribosomal-DNA amplifications.Quantitative-competitive PCR monitored the decrease of parasitic load duringtreatment and secondary prophylaxis with benznidazole. The synergy betweenparasiticidal plus anti-retroviral treatments probably allowed the patient alonger survival than usually achieved in similar episodes. This is the first casereport demonstrating a differential distribution of natural parasite populations and sublineages in Chagas disease reactivation, showing the proliferation ofcerebral variants not detectable in peripheral blood