Treatment of Chronic Chagas Disease with Benznidazole: clinical and serological evolution of patients with long-term follow

VIOTTI R; VIGLIANO C; ARMENTI H; SEGURA E

Year Book of Infectious Diseases

MOSBY

Año: 1995; p. 208 - 209

Background. Tens of millions of LatIn Americans living in endemic regions are at risk of contracting Chagas´ disease (American trypanosoniasis). As many as 20 million persons living in both rural and urban areas are infected by Trypanosoma cruzi. The chronic myocarditis that results is frequently fatal. Attempts to treat Chagas´ disease have focused in eliminating T. cruzi infection using agents that can destroy the parasite in the host. Qbjective. The effect of treatment with benznidazole on the course of cardiomyopathy was examined in 70 untreated patients and 131 others who received the drug in a daily dose of 5 mg/kg for 1 month. The average follow-up was 8 years. Observations. The effects of active treatment in patients younger than 50 years of age who were only serologically positive (group I), had an abnormal cardiothoracic ratio (group II), or had clinical or radiologic signs of heart failure (group III) are shown in the table. Treated patients had fewer ECG abnormalities during follow-up than untreated patients, and clinical deterioration was much less frequent (2% vs. 17%). Nineteen percent of actively treated patients and 6% of untreated control patients became serologically negative. No patient was withdrawn because side effects of benznidazole treatment. Conclusion. One month of benznidazole treatment appears to slow the progress of cardiomyopathy in patients who have Chagas´ disease, whether they are assessed clinically or electrocardiographically. In addition, antibody titers decline more in patients who are given this drug.