Perinatal human immunodeficiency virus infection and congenital Chagas' disease

FREILIJ H; ALTCHEH J; MUCHINIK G

PEDIATRIC INFECTIOUS DISEASE JOURNAL

LIPPINCOTT WILLIAMS & WILKINS

Lugar: Philadelphia; Año: 1995 vol. 14 p. 161 - 162

0891-3668

Chagas´ disease, the etiologic agent of which is Trypano-soma cruzi, is a major health problem in Latin America. The disease is found from the south of the United States to Argentina, and some 20 million people are afflicted.1 The infection is acquired by three main routes: through the bite of the hematophagous triatomine insect (the natural vector), which deposits excreta containing infectious tripomastigotes that contaminate the bite site, through blood transfusion or transplacentally. Spontaneous resolution of the acute illness occurs commonly and the infection enters into an indetermi-nate phase, characterized by lifelong low grade parasitemia, antibodies to parasite antigens and absence of symptoms. Only 20 to 30% of infected people develop cardiac or gastro-intestinal lesions.During pregnancy an infected mother in the acute or chronic stage of infection can transmit the parasite to her fetus.2"4 In Buenos Aires, a nonendemic area for Chagas´ disease, 6 to 8% of pregnant mothers delivering at public hospitals have reactive serology to T. cruzi; 2 to 4% of them will have infected children.0Another growing problem in Argentina is human immuno-deficiency virus (HIV) infection in pediatric patients. Prelim-inary serologic data in Buenos Aires, recently confirmed by HIV culture,8 suggest a 35% perinatal transmission of the virus.