New scheme of intermittent benznidazole administration in patients chronically infected with Trypanosoma cruzi : Clinical, parasitological and serological assessment after three years of follow-up.

BERTOCCHI, GRACIELA; LOCOCO, BRUNO; CURA, CAROLINA; TARLETON, RICK L.; SOSA-ESTANI, SERGIO; RAMÍREZ, JUAN CARLOS; HERNÁNDEZ, YOLANDA; SCHIJMAN, ALEJANDRO; LAUCELLA, SUSANA; CASTRO EIRO, MELISA; ÁLVAREZ, MARÍA GABRIELA; FERNÁNDEZ, MARISA; LOPEZ-ALBIZU, CONSTANZA; ABRIL, MARCELO; NATALE, MARÍA AILEN; VIOTTI, RODOLFO

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY

AMER SOC MICROBIOLOGY

Lugar: Washington; Año: 2020 vol. 64

0066-4804

1 Introduction. In a pilot study, we showed that intermittent administration of benznidazole in chronic Chagas disease patients resulted in a low rate of treatment suspension and therapeutic failure, as assessed by qPCR at the end of treatment. Herein, a three-year post-treatment follow-up study of the same cohort of patients is presented. Methods. The treatment scheme consisted of 12 doses of benznidazole at 5 mg/kg/day in two daily doses every 5 days. Parasite load, T. cruzi-specific antibodies and serum chemokine levels were measured prior to treatment and after a median follow-up of 36 months post-treatment by28 kDNA and SatDNA qPCR methods, conventional serological techniques and a Luminex-based assay with recombinant T. cruzi protein, and a cytometric bead array, respectively. Results. At the end of follow-up, 14 of 17 (82%) patients had negative qPCR findings, whereas three of 17 (18%) had detectable nonquantifiable findings by at least one of the qPCR techniques. A decline in parasite-specific antibodies at 12 months post-treatment was confirmed by conventional serological tests and the Luminex assays. Monocyte chemoattractant protein-1 (MCP34 1) levels increased after treatment, whereas monokine induced by gamma interferon (MIG) levels decreased. New post-treatment electrocardiographic abnormalities were observed in only onepatient who had cardiomyopathy prior to treatment. Conclusions. Altogether, these data strengthen our previous findings by showing that the intermittent administration of benznidazole results in a low rate of treatment suspension, with comparable treatment efficacy to that of a daily dose of 5mg/kg for 60 days.