Clinical and epidemiological features of chronic Trypanosoma cruzi infection in patients with HIV/AIDS in Buenos Aires, Argentina.

ANDRES BENCHETIT; MARISA FERNANDEZ; AMADEO JAVIER BAVA; MARCELO CORTI; NORMA PORTEIRO; LILIANA MARTINEZ PERALTA

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES : IJID : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR INFECTIOUS DISEASES.

ELSEVIER SCI LTD

Lugar: Amsterdam; Año: 2018 vol. 67 p. 118 - 121

1201-9712

Objectives: Trypanosoma cruzi (T. cruzi) reactivation in HIV patients is considered an opportunistic infection, usually with fatal outcome. The aim of this study was to describe epidemiological and clinical features of T. cruzi infection in HIV patients, and compare these findings between patients with and without Chagas disease reactivation.Methods: Medical records of T. cruzi-HIV co-infected patients assisted at the Muñiz Infectious Diseases Hospital from January 2005 to December 2014 were retrospectively reviewed. Epidemiological and clinical features were assessed and compared between patients with and without Chagas disease reactivation.Results: The medical records of 80 T. cruzi-HIV co-infected patients were reviewed. The most likely route of T. cruzi infection was vector-borne, 32/80 patients, followed by intravenous drug use in 12/80. There were 9/80 patients with reactivation. Patients without reactivation had a significantly higher CD4 T cell count at T. cruzi infection diagnosis (144 cells/µl vs. 30cells/µl, p = 0.026). Chagas disease serology was negative in 2/9 patients with reactivation. Conclusion: Serological assays for T.cruzi infection could be negative in severely immunodeficient patients. Direct parasitological techniques should be performed in patients with suspicion of T. cruzi reactivation. HIV patients with lower CD4 count are at higher risk of reactivation.